OrganizationActive
Elderly Behavioral Wellness Services Inc
NPI 1871983106 · Adult Development & Aging Psychologist · Los Angeles, CA
Provider details
- NPI number
- 1871983106
- Entity type
- Organization
- Primary specialty
- Adult Development & Aging PsychologistBehavioral Health & Social Service Providers
- Organization subpart
- No
- Authorized official
- Eleni Bagourdi, Ceo(310) 999-9683
- License
- PSY22542 (CA)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Practice location
2001 S Barrington Ave Ste 314
Los Angeles, CA 90025-5379
Phone: (310) 999-9683
Approximate (ZIP-level) locationGet directions
Mailing address
2001 S Barrington Ave Ste 314
Los Angeles, CA 90025-5379
Registry dates
- Enumerated
- 2015-01-26
- Last updated
- 2021-06-01
- Certified
- 2021-06-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.