Provider Demographics
NPI:1376047613
Name:BEVERLY ACCORD THERPAY
Entity Type:Organization
Organization Name:BEVERLY ACCORD THERPAY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:
Authorized Official - First Name:FARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:SAFAEI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-570-3150
Mailing Address - Street 1:170 S BEVERLY DR STE 307
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-3000
Mailing Address - Country:US
Mailing Address - Phone:310-951-4356
Mailing Address - Fax:
Practice Address - Street 1:170 S BEVERLY DR STE 307
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-3000
Practice Address - Country:US
Practice Address - Phone:310-951-4356
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-21
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT83509261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)