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Organization
NEW ANTIOCH COGIC
Active
Organization
NEW ANTIOCH COGIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LAQUITA S. SUGGS LCSW (CLINICAL DIRECTOR)
(323) 778-7965
Entity
Organization
Contact information
Practice address
7826 S VERMONT AVE, LOS ANGELES, CA 90044-3530
(323) 778-7965
Mailing address
7826 S VERMONT AVE, LOS ANGELES, CA 90044-3530
(323) 778-7965
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW20459
CA
251S00000X
Community/Behavioral Health Agency
LCSW20459
CA
Other
Enumeration date
09/23/2015
Last updated
09/23/2015
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