Provider Demographics
NPI:1962831990
Name:VIP COMMUNITY MENTAL HEALTH CENTER, INC.
Entity Type:Organization
Organization Name:VIP COMMUNITY MENTAL HEALTH CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:ARMALY
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:323-221-4134
Mailing Address - Street 1:1721 GRIFFIN AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90031-3312
Mailing Address - Country:US
Mailing Address - Phone:323-221-4134
Mailing Address - Fax:323-221-4231
Practice Address - Street 1:456 S MATHEWS ST
Practice Address - Street 2:THEODORE ROOSEVELT HIGH SCHOOL
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-4326
Practice Address - Country:US
Practice Address - Phone:323-221-4134
Practice Address - Fax:323-221-4231
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-12
Last Update Date:2014-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health