KW Management Enterprises, LLC

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFC 41490 Issued in CA

Legal business name

KW MANAGEMENT ENTERPRISES, LLC

Doing business as

Life Adjustment Team Advanced IOP Therapies

Practice address

11936 Jefferson Blvd
Suite E
Culver City, CA 90230-6333

Phone

(310) 572-7000

Fax

(310) 642-5902

NPI assigned

May 29, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Andy Piskoulian

Title

Ceo

Phone

(310) 572-7000

Specialties & licenses 3

Addresses

Other names 1

• Life Adjustment Team Advanced IOP Therapies Doing business as

Locations

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

{
    "created_epoch": "1369785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370563200000",
    "number": "1770920860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 W CENTINELA AVE",
            "address_2": "SUITE 375",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902306337",
            "telephone_number": "310-572-7000",
            "fax_number": "310-642-5902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11936 JEFFERSON BLVD",
            "address_2": "SUITE E",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902306333",
            "telephone_number": "310-572-7000",
            "fax_number": "310-642-5902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KW MANAGEMENT ENTERPRISES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-29",
        "last_updated": "2013-06-07",
        "status": "A",
        "authorized_official_last_name": "PISKOULIAN",
        "authorized_official_first_name": "ANDY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-572-7000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "MFC 41490",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "MFC 41490",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 41490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Life Adjustment Team Advanced IOP Therapies",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Marriage & Family Therapist in Culver City, CA
• Providers in Culver City, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2013; 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.