Provider Demographics
NPI:1750993796
Name:DAMAARU, INC.
Entity type:Organization
Organization Name:DAMAARU, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:
Authorized Official - Last Name:KLEIST
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:901-235-9018
Mailing Address - Street 1:3553 ATLANTIC AVE # 168
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-5606
Mailing Address - Country:US
Mailing Address - Phone:901-235-9018
Mailing Address - Fax:562-606-2151
Practice Address - Street 1:920 N AVALON BLVD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:CA
Practice Address - Zip Code:90744-4504
Practice Address - Country:US
Practice Address - Phone:901-235-9018
Practice Address - Fax:562-606-2151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-20
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health