Provider Demographics
NPI:1609582162
Name:LA EMPOWERING MINDS YOUTH SERVICES
Entity Type:Organization
Organization Name:LA EMPOWERING MINDS YOUTH SERVICES
Other - Org Name:LEMYS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-452-5920
Mailing Address - Street 1:7080 HOLLYWOOD BLVD STE 1100
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90028-6938
Mailing Address - Country:US
Mailing Address - Phone:323-452-5920
Mailing Address - Fax:
Practice Address - Street 1:7080 HOLLYWOOD BLVD STE 1100
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90028-6938
Practice Address - Country:US
Practice Address - Phone:323-452-5920
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-27
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No251B00000XAgenciesCase Management