Provider Demographics
NPI:1124520606
Name:NARCISSE, MEREDITH
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:
Last Name:NARCISSE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3709 RUTHELEN STREET
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90018
Mailing Address - Country:US
Mailing Address - Phone:323-246-8920
Mailing Address - Fax:
Practice Address - Street 1:AEGIS TREATMENT CENTER 14240 IMPERIAL HWY
Practice Address - Street 2:
Practice Address - City:LA MIRIDA
Practice Address - State:CA
Practice Address - Zip Code:90638
Practice Address - Country:US
Practice Address - Phone:562-946-1587
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-01
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)