Organization
BLYTHE PROJECT LLC
Active
Other names
Blythe Project LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DENNIS MATTHEWS (MANAGER PARTNER)
(949) 394-3221
Entity
Organization
Contact information
Practice address
16501 VENTURA BLVD STE 450, ENCINO, CA 91436-2068
(949) 394-3221
Mailing address
16501 VENTURA BLVD STE 400, ENCINO, CA 91436-2067
(949) 394-3221
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YP1600X
Pastoral Counselor
Primary
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261QC1500X
Community Health Clinic/Center
—
—
261QH0100X
Health Service Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QV0200X
VA Clinic/Center
—
—
Other
Enumeration date
07/02/2024
Last updated
07/02/2024
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