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
JAMES J MANGIA (CHIEF EXECUTIVE OFFICER)
(323) 541-1660
Entity
Organization
Contact information
Practice address
5701 S HOOVER ST, LOS ANGELES, CA 90037-4045
(323) 541-1400
(323) 541-1401
Mailing address
808 W 58TH ST, LOS ANGELES, CA 90037-3632
(323) 541-1660
(323) 541-1661
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
550000088
CA
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013057371
—
CA
05
—
FHC 71106F
—
CA
Enumeration date
02/07/2007
Last updated
02/12/2024
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