Provider Demographics
NPI:1710735741
Name:GLOBAL QUANTUM HEALING SANCTUARY LLC
Entity type:Organization
Organization Name:GLOBAL QUANTUM HEALING SANCTUARY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SELENE
Authorized Official - Middle Name:
Authorized Official - Last Name:KEPILA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-965-6821
Mailing Address - Street 1:5038 PARKWAY CALABASAS STE 100
Mailing Address - Street 2:
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-2560
Mailing Address - Country:US
Mailing Address - Phone:310-965-6821
Mailing Address - Fax:
Practice Address - Street 1:5038 PARKWAY CALABASAS STE 100
Practice Address - Street 2:
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-2560
Practice Address - Country:US
Practice Address - Phone:310-965-6821
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center