Provider Demographics
NPI:1598476764
Name:FIRST MENTAL WELLNESS
Entity Type:Organization
Organization Name:FIRST MENTAL WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:GENE
Authorized Official - Last Name:RUBISH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:970-216-0747
Mailing Address - Street 1:8549 WILSHIRE BLVD # 1113
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-3104
Mailing Address - Country:US
Mailing Address - Phone:970-216-0747
Mailing Address - Fax:
Practice Address - Street 1:8242 SUNNYSEA DR
Practice Address - Street 2:
Practice Address - City:PLAYA DEL REY
Practice Address - State:CA
Practice Address - Zip Code:90293-7941
Practice Address - Country:US
Practice Address - Phone:970-216-0747
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-08
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty