Provider Demographics
NPI:1760123483
Name:GRAYCOLORS INC
Entity Type:Organization
Organization Name:GRAYCOLORS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MIKEA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:310-418-7285
Mailing Address - Street 1:3657 W CHAPMAN LN
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90305-2300
Mailing Address - Country:US
Mailing Address - Phone:310-418-7285
Mailing Address - Fax:
Practice Address - Street 1:10835 SANTA MONICA BLVD STE 100
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-4691
Practice Address - Country:US
Practice Address - Phone:310-418-7285
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-05
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251S00000XAgenciesCommunity/Behavioral Health
No252Y00000XAgenciesEarly Intervention Provider AgencyGroup - Multi-Specialty