Provider Demographics
NPI:1497177547
Name:TELEHEALTH
Entity Type:Organization
Organization Name:TELEHEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NADIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ISLAM
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:213-821-5918
Mailing Address - Street 1:6730 OVERVIEW DR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-7652
Mailing Address - Country:US
Mailing Address - Phone:240-475-7270
Mailing Address - Fax:
Practice Address - Street 1:3375 S HOOVER ST STE H201
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90089-0116
Practice Address - Country:US
Practice Address - Phone:866-740-6502
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-08
Last Update Date:2014-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management