Provider Demographics
NPI:1124605126
Name:GUIDING OUR YOUTH
Entity Type:Organization
Organization Name:GUIDING OUR YOUTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEAD OF SERVICE
Authorized Official - Prefix:
Authorized Official - First Name:MARAL
Authorized Official - Middle Name:PUSHIAN
Authorized Official - Last Name:SULTANIAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LMFT
Authorized Official - Phone:805-296-8677
Mailing Address - Street 1:1197 E LOS ANGELES AVE # C-338
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-2868
Mailing Address - Country:US
Mailing Address - Phone:818-395-0892
Mailing Address - Fax:
Practice Address - Street 1:2136 CUTLER ST
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-4923
Practice Address - Country:US
Practice Address - Phone:805-527-1166
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-25
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children