Provider Demographics
NPI:1265960512
Name:LOVE AND LIGHT COUSELING SERVICES
Entity type:Organization
Organization Name:LOVE AND LIGHT COUSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GOLNAR
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAHEDIN-LABBAF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-383-3436
Mailing Address - Street 1:4201 LONG BEACH BLVD STE 203
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-2020
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4201 LONG BEACH BLVD STE 203
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807
Practice Address - Country:US
Practice Address - Phone:310-383-3436
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-31
Last Update Date:2018-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)