Organization
PRIME WELLNESS COMMUNITY HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENYS SLESARENKO (CEO)
(310) 659-7867
Entity
Organization
Contact information
Practice address
8610 S SEPULVEDA BLVD STE 104, LOS ANGELES, CA 90045-4009
(310) 659-7867
(310) 878-2118
Mailing address
8610 S SEPULVEDA BLVD STE 104, LOS ANGELES, CA 90045-4009
(310) 659-7867
(310) 878-2118
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
12/03/2019
Last updated
02/05/2025
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