Provider Demographics
NPI:1164847133
Name:NEXT MOVE ANENCY
Entity type:Organization
Organization Name:NEXT MOVE ANENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BAHBAH
Authorized Official - Middle Name:
Authorized Official - Last Name:MAKOUIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-553-0432
Mailing Address - Street 1:14717 HAWTHORNE BLVD
Mailing Address - Street 2:#B
Mailing Address - City:LAWNDALE
Mailing Address - State:CA
Mailing Address - Zip Code:90260-1549
Mailing Address - Country:US
Mailing Address - Phone:310-553-0432
Mailing Address - Fax:213-402-2101
Practice Address - Street 1:11270 EXPOSITION BLVD
Practice Address - Street 2:#642931
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-5903
Practice Address - Country:US
Practice Address - Phone:310-553-0432
Practice Address - Fax:213-402-2101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-27
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 52448251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1437468782OtherNPI