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Organization
PRIDE HEALTH SERVICES
Active
Organization
PRIDE HEALTH SERVICES
Active
Other names
Pride Health Services Crenshaw
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GODFREY NWOGENE (EXECUTIVE DIRECTOR)
(310) 677-9091
Entity
Organization
Contact information
Practice address
8619 CRENSHAW BLVD, INGLEWOOD, CA 90305-2330
(310) 766-9019
(310) 677-9401
Mailing address
8619 CRENSHAW BLVD, INGLEWOOD, CA 90305-2330
(310) 766-9019
(310) 677-9401
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
701231
DRUG MEDI-CAL
CA
Enumeration date
04/23/2007
Last updated
07/21/2022
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