Provider Demographics
NPI:1770920860
Name:KW MANAGEMENT ENTERPRISES, LLC
Entity type:Organization
Organization Name:KW MANAGEMENT ENTERPRISES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:PISKOULIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-572-7000
Mailing Address - Street 1:6101 W CENTINELA AVE
Mailing Address - Street 2:SUITE 375
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-6337
Mailing Address - Country:US
Mailing Address - Phone:310-572-7000
Mailing Address - Fax:310-642-5902
Practice Address - Street 1:11936 JEFFERSON BLVD
Practice Address - Street 2:SUITE E
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-6333
Practice Address - Country:US
Practice Address - Phone:310-572-7000
Practice Address - Fax:310-642-5902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-29
Last Update Date:2013-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 41490101YA0400X, 101YM0800X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty