Provider Demographics
NPI:1124868906
Name:MAGIC WINDS, INC.
Entity type:Organization
Organization Name:MAGIC WINDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARINE
Authorized Official - Middle Name:
Authorized Official - Last Name:BALYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-860-6802
Mailing Address - Street 1:400 THOMPSON AVE # 106
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91201-2572
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:400 THOMPSON AVE # 106
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91201-2572
Practice Address - Country:US
Practice Address - Phone:818-860-6802
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-29
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty