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1730378266
KEITH EVERAGE
LOS ANGELES, CA
NPI
1730378266
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA 7222)
Enumeration Date
2007-10-22
Last Update Date
2007-10-22
Business Address
-- KEITH EVERAGE
11502 S VERMONT AVE # D
LOS ANGELES, CA 90044-6522
Phone number: 323-755-2742
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Mailing Address
-- KEITH EVERAGE
8306 WILSHIRE BLVD #7024
BEVERLY HILLS, CA 90211-2304
Phone number: 323-755-2742
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