Organization
BEHAVIORAL HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TERESA CANNON (CHEIF COMPLIANCE OFFICER)
(310) 679-2920
Entity
Organization
Contact information
Practice address
15519 CRENSHAW BLVD, GARDENA, CA 90249-4525
(310) 679-9126
(310) 679-2800
Mailing address
15519 CRENSHAW BLVD, GARDENA, CA 90249-4525
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
CA
Other
Enumeration date
11/20/2009
Last updated
11/20/2009
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