# VENICE FAMILY CLINIC

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

## Provider details

- **NPI number:** 1457510208
- **Authorized official:** ELIZABETH FORER MSW MPH (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (310) 664-7901

## Contact information

- **Practice address:** 604 ROSE AVE, VENICE, CA 90291-2767
- **Practice address phone:** (310) 392-8630
- **Mailing address:** 604 ROSE AVE, VENICE, CA 90291-2767

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QC1500X | Community Health Clinic/Center | 960000169 | CA | Yes |

## Other

- **Enumeration date:** 06/06/2008
- **Last updated:** 02/26/2010