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Organization

TOTAL FAMILY SUPPORT CLINIC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. MARINA VERKHOVSKY MS (DIRECTOR OF HR)
(213) 213-0581
Entity
Organization

Contact information

Practice address
1921 MAPLE AVE, LOS ANGELES, CA 90011-1036
(213) 763-1030
(213) 742-9883
Mailing address
830 S OLIVE ST, LOS ANGELES, CA 90014-3006
(213) 213-0581
(213) 213-0580

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
197464
CA
Enumeration date
05/10/2012
Last updated
05/10/2012
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