Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Tylyce Farms

Organization Addiction (Substance Use Disorder) Counselor · NPI 1205424405

Tylyce Farms is an Addiction (Substance Use Disorder) Counselor in Los Angeles, California. Registered with an NPI since 2021.

In the registry since
2021
Specialties on file
3

Practice location Address checks out

1937 E 111th St
Los Angeles, CA 90059-2001
Phone: (661) 797-4018
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Home Health Agency (primary) Taxonomy 251E00000X
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X
Licensed Psychiatric Technician Taxonomy 167G00000X

Record details

NPI number1205424405
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationMagenta Sky Pr
Authorized official Charde Petrus — Director · (661) 797-4018
Other names Magenta Haze Pr
NPI enumeratedJanuary 5, 2021
Last updated in NPPESJanuary 5, 2021
Certification dateJanuary 4, 2021
Mailing address3231 Key Largo Dr Apt 202, Las Vegas, NV 89120-5304

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