Organization
COUNTY OF LOS ANGELES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VIVIAN B WATTS REGISTERED NURSE (MENTAL HEALTH COUNSELOR RN)
(310) 668-6862
Entity
Organization
Contact information
Practice address
3811 EDGEHILL DR, LOS ANGELES, CA 90008-1932
(323) 291-7275
Mailing address
3811 EDGEHILL DR, LOS ANGELES, CA 90008-1932
(323) 291-7275
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
328506
CA
Other
Enumeration date
11/02/2006
Last updated
08/22/2020
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