Provider Demographics
NPI:1053026930
Name:AMALY
Entity type:Organization
Organization Name:AMALY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:HALIMA
Authorized Official - Middle Name:
Authorized Official - Last Name:EID
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:619-841-1457
Mailing Address - Street 1:2615 SWEETWATER SPRINGS BLVD STE G48
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91978-1709
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2615 SWEETWATER SPRINGS BLVD STE G
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91978-1725
Practice Address - Country:US
Practice Address - Phone:760-498-4160
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-16
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty