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Organization
SPECIAL SERVICE FOR GROUPS
Active
Organization
SPECIAL SERVICE FOR GROUPS
Active
Other names
SSG-CHLA
Organization subpart
No
Provider details
NPI number
Authorized official
HERBERT K. HATANAKA DSW (EXECUTIVE DIRECTOR)
(213) 553-1800
Entity
Organization
Contact information
Practice address
5000 W SUNSET BLVD, 4TH FLOOR, LOS ANGELES, CA 90027-5861
(323) 361-3903
Mailing address
605 W OLYMPIC BLVD, SUITE 600, LOS ANGELES, CA 90015-1400
(213) 553-1800
(213) 553-1822
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
01/15/2008
Last updated
01/15/2008
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