Organization
ST. JOHNS COMMUNITY HEALTH
Active
Other names
St. John's Well Child and Family Center, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES MANGIA (PRESIDENT, CEO)
(323) 541-1600
Entity
Organization
Contact information
Practice address
6505 8TH AVE, LOS ANGELES, CA 90043-4313
(323) 541-1600
(323) 541-1665
Mailing address
808 W 58TH ST, LOS ANGELES, CA 90037-3632
(323) 541-1600
(323) 541-1665
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
171W00000X
Contractor
—
—
251B00000X
Case Management Agency
—
—
251X00000X
Supports Brokerage Agency
—
—
261QC1500X
Community Health Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003068206
—
CA
Enumeration date
10/21/2008
Last updated
02/12/2024
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