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Organization
LACO PROBATION DEPT
Active
Organization
LACO PROBATION DEPT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARIO PROVINCIO (DIRECTOR)
(310) 603-7311
Entity
Organization
Contact information
Practice address
9150 IMPERIAL HWY RM P-31, DOWNEY, CA 90242-2835
(562) 940-3694
(562) 658-7425
Mailing address
200 W COMPTON BLVD STE 300, COMPTON, CA 90220-3136
(310) 603-7918
(310) 638-1755
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
03/04/2011
Last updated
03/04/2011
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