Provider Demographics
NPI:1871395442
Name:POWERED BY GRATITUDE
Entity type:Organization
Organization Name:POWERED BY GRATITUDE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LARON
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:RANDOLPH
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:323-677-1724
Mailing Address - Street 1:6071 GOLD SPIRIT ST
Mailing Address - Street 2:
Mailing Address - City:EASTVALE
Mailing Address - State:CA
Mailing Address - Zip Code:92880-0989
Mailing Address - Country:US
Mailing Address - Phone:323-677-1724
Mailing Address - Fax:
Practice Address - Street 1:6071 GOLD SPIRIT ST
Practice Address - Street 2:
Practice Address - City:EASTVALE
Practice Address - State:CA
Practice Address - Zip Code:92880-0989
Practice Address - Country:US
Practice Address - Phone:323-677-1724
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-25
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174200000XOther Service ProvidersMeals
No177F00000XOther Service ProvidersLodging
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
No251V00000XAgenciesVoluntary or Charitable
No253Z00000XAgenciesIn Home Supportive Care
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No405300000XOther Service ProvidersPrevention ProfessionalGroup - Multi-Specialty