| Ignite Collective, Inc | |
|
810 Lawrence Dr Ste 100 Newbury Park CA 91320-6615 | |
| (805) 500-6597 | |
| Not Available |
| Full Name | Ignite Collective, Inc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 810 Lawrence Dr Ste 100, Newbury Park, California |
| Authorized Official Name and Position | Morgan Dias (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3102436790 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ignite Collective, Inc 16639 Cantlay St Van Nuys CA 91406-2806 Ph: () - | Ignite Collective, Inc 810 Lawrence Dr Ste 100 Newbury Park CA 91320-6615 Ph: (805) 500-6597 |
| NPI Number | 1205602794 |
|---|---|
| Provider Enumeration Date | 11/27/2023 |
| Last Update Date | 01/12/2024 |
| Certification Date | 01/12/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205602794 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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