| Memoryco, Llc | |
|
2248 Saint Bernard Drive Pine Mountain Club CA 93222 | |
| (323) 486-3626 | |
| Not Available |
| Full Name | Memoryco, Llc |
|---|---|
| Speciality | Counselor |
| Location | 2248 Saint Bernard Drive, Pine Mountain Club, California |
| Authorized Official Name and Position | Ali S Titiz (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 6505213452 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Memoryco, Llc Po Box 5253 Pine Mountain Club CA 93222-5253 Ph: (323) 486-3626 | Memoryco, Llc 2248 Saint Bernard Drive Pine Mountain Club CA 93222 Ph: (323) 486-3626 |
| NPI Number | 1780137596 |
|---|---|
| Provider Enumeration Date | 07/28/2016 |
| Last Update Date | 07/28/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780137596 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
Dr. Elizabeth Wise Licensed Clinical Social Worker Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2500 Cedarwood Dr., Pine Mountain Club, CA 93222 Phone: 310-422-2047 | |
George Calasa Licensed Professional Clinical Counselor Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 16321 Askin Dr # 6688, Pine Mountain Club, CA 93222 Phone: 805-850-3057 |