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Organization
MODUPEOLA OLAJUMOKE ADEDEJI
Active
Organization
MODUPEOLA OLAJUMOKE ADEDEJI
Active
Other names
La Paz Community Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ADEDIRAN ADEDEJI (CEO)
(210) 697-5700
Entity
Organization
Contact information
Practice address
530 SAN PEDRO AVE, SAN ANTONIO, TX 78212-5006
(210) 697-5700
(210) 558-9032
Mailing address
530 SAN PEDRO AVE, SAN ANTONIO, TX 78212-5006
(210) 697-5700
(210) 558-9032
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021375301
—
TX
Enumeration date
12/30/2005
Last updated
09/27/2012
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