Provider Demographics
NPI:1205370525
Name:OUR VILLAGE
Entity Type:Organization
Organization Name:OUR VILLAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER & EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:A
Authorized Official - Last Name:FYFE
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:310-968-5711
Mailing Address - Street 1:3858 W. CARSON ST.
Mailing Address - Street 2:SUITE #120
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503
Mailing Address - Country:US
Mailing Address - Phone:424-206-1441
Mailing Address - Fax:
Practice Address - Street 1:3858 W. CARSON ST.
Practice Address - Street 2:SUITE #120
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503
Practice Address - Country:US
Practice Address - Phone:424-206-1441
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-05
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47541251S00000X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health