Organization
FRED JEFFERSON
Active
Other names
Fred Jefferson 142
Organization subpart
No
Provider details
NPI number
Authorized official
DARRYL SEWELL (CHIEF ADMINISTRATIVE OFFICER)
(310) 929-0738
Entity
Organization
Contact information
Practice address
1448 E 142ND ST, COMPTON, CA 90222-3702
(310) 763-1660
(310) 763-0357
Mailing address
1448 E 142ND ST, COMPTON, CA 90222-3702
(310) 929-0738
(310) 763-0357
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
11/28/2016
Last updated
01/27/2017
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