# JWCH INSTITUTE, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** JWCH Medical Clinic - Covenant House California
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528515152
- **Authorized official:** ALVARO P. BALLESTEROS (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (323) 201-4516

## Contact information

- **Practice address:** 1325 N WESTERN AVE, LOS ANGELES, CA 90027-5615
- **Practice address phone:** (323) 461-3131
- **Practice address fax:** (323) 957-7419
- **Mailing address:** 5650 JILLSON STREET, COMMERCE, CA 90040-1482
- **Mailing address phone:** (323) 201-4516
- **Mailing address fax:** (323) 215-0170

## Taxonomy

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

## Other

- **Enumeration date:** 09/01/2016
- **Last updated:** 09/01/2016