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Organization
SOUTHERN CALIFORNIA HEALTH & REHABILITATION PROGRAM
Active
Organization
SOUTHERN CALIFORNIA HEALTH & REHABILITATION PROGRAM
Active
Other names
SCHARP Child Outpatient Services
Organization subpart
No
Provider details
NPI number
Authorized official
JACK M BARBOUR MD (CEO/PRESIDENT)
(310) 631-8004
Entity
Organization
Contact information
Practice address
2594 INDUSTRY WAY, LYNWOOD, CA 90262-4015
(310) 667-4070
(310) 667-4072
Mailing address
2610 INDUSTRY WAY, SUITE A, LYNWOOD, CA 90262-4028
(310) 631-8004
(310) 631-7830
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7654
PROVIDER NUMBER
CA
Enumeration date
03/28/2007
Last updated
05/09/2018
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