Provider Demographics
NPI:1568839066
Name:PRISM ENTERPISES, INC.
Entity Type:Organization
Organization Name:PRISM ENTERPISES, INC.
Other - Org Name:PRISM BEHAVIORAL SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LUSINE
Authorized Official - Middle Name:
Authorized Official - Last Name:GABRIELYAN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:877-206-1009
Mailing Address - Street 1:21600 OXNARD ST. SUITE 1030
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91357
Mailing Address - Country:US
Mailing Address - Phone:877-206-1009
Mailing Address - Fax:818-457-4617
Practice Address - Street 1:21600 OXNARD ST. SUITE 1030
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91357
Practice Address - Country:US
Practice Address - Phone:877-206-1009
Practice Address - Fax:818-457-4617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-01
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-10-7411103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty