Provider Demographics
NPI:1336506997
Name:HEIGHTS CENTER FOR COUNSELING AND WELLNESS, INC
Entity Type:Organization
Organization Name:HEIGHTS CENTER FOR COUNSELING AND WELLNESS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RODDY
Authorized Official - Middle Name:
Authorized Official - Last Name:SUOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-800-1442
Mailing Address - Street 1:440 REDONDO AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90814-5143
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:440 REDONDO AVE STE 103
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90814-5143
Practice Address - Country:US
Practice Address - Phone:310-800-1442
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-26
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty