Provider Demographics
NPI:1184003139
Name:GREGORY E. ALLEN, FAMILY COUNSELING, INC.
Entity Type:Organization
Organization Name:GREGORY E. ALLEN, FAMILY COUNSELING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:EARL
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-378-9005
Mailing Address - Street 1:336 TEJON PL
Mailing Address - Street 2:
Mailing Address - City:PALOS VERDES ESTATES
Mailing Address - State:CA
Mailing Address - Zip Code:90274-1204
Mailing Address - Country:US
Mailing Address - Phone:310-378-9005
Mailing Address - Fax:310-378-3024
Practice Address - Street 1:336 TEJON PL
Practice Address - Street 2:
Practice Address - City:PALOS VERDES ESTATES
Practice Address - State:CA
Practice Address - Zip Code:90274-1204
Practice Address - Country:US
Practice Address - Phone:310-378-9005
Practice Address - Fax:310-378-3024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-23
Last Update Date:2015-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17674276400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes276400000XHospital UnitsRehabilitation, Substance Use Disorder Unit