Provider Demographics
NPI:1437937539
Name:TO LIVE & PLAY IN LA
Entity Type:Organization
Organization Name:TO LIVE & PLAY IN LA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CLAYTON
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT #107668
Authorized Official - Phone:310-386-6670
Mailing Address - Street 1:7341 VALMONT ST # 101
Mailing Address - Street 2:
Mailing Address - City:TUJUNGA
Mailing Address - State:CA
Mailing Address - Zip Code:91042-2213
Mailing Address - Country:US
Mailing Address - Phone:310-386-6670
Mailing Address - Fax:
Practice Address - Street 1:7341 VALMONT ST # 101
Practice Address - Street 2:
Practice Address - City:TUJUNGA
Practice Address - State:CA
Practice Address - Zip Code:91042-2213
Practice Address - Country:US
Practice Address - Phone:310-386-6670
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-19
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty