Organization
BEHAVIORAL HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FELIPE RODRIGUEZ CLINICAL SUPERVISOR (SUPERVISOR)
(323) 221-1746
Entity
Organization
Contact information
Practice address
4099 N MISSION RD, LOS ANGELES, CA 90032-2554
(323) 221-1746
(323) 221-7156
Mailing address
4099 N MISSION RD, LOS ANGELES, CA 90032-2554
(323) 221-1746
(323) 221-7156
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
—
—
Other
Enumeration date
03/05/2012
Last updated
03/05/2012
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