Eye4Peace Community Services Corporation

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

EYE4PEACE COMMUNITY SERVICES CORPORATION

Practice address

11311 Hawthorne Blvd Unit 1
Inglewood, CA 90304-2775

Phone

(310) 484-4177

NPI assigned

Jun 6, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tracy Nibo, LCSWNPI 1750763108

Title

Chief Operating Officer

Phone

(310) 484-4177

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tracy Nibo

  • Mental Health Counselor
  • Los Angeles, CA
  • NPI 1750763108
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1686009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686009600000",
    "number": "1255025862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11311 HAWTHORNE BLVD UNIT 1",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903042775",
            "telephone_number": "310-484-4177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11311 HAWTHORNE BLVD UNIT 1",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903042775",
            "telephone_number": "310-484-4177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE4PEACE COMMUNITY SERVICES CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-06",
        "last_updated": "2023-06-06",
        "certification_date": "2023-06-06",
        "status": "A",
        "authorized_official_last_name": "NIBO",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "310-484-4177",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lillian Evans
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• Michelle E Faello, RD
• Fair Care Medical Supply, Inc
• Faithful Central Bible Church
• Families for Children Inc
• Families for Children, Inc.

• Mental Health Clinic/Center (Including Community Mental Health Center) in Inglewood, CA
• Providers in Inglewood, CA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.