# WITHROW OUT A TRACE MINISTYR

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235371352
- **Authorized official:** MR. VINCENT M DUGAN REGISTER COUNSELOR (COUNSELOR)
- **Authorized official phone:** (213) 880-9242

## Contact information

- **Practice address:** 2110 ARTESIA BLVD, REDONDO BEACH, CA 90278-3073
- **Practice address phone:** (310) 569-5868
- **Mailing address:** 4015 W 137TH ST, HAWTHORNE, CA 90250-7340
- **Mailing address phone:** (310) 569-5868

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | RW2056 | CA | Yes |

## Other

- **Enumeration date:** 04/03/2009
- **Last updated:** 04/03/2009