Organization
CRENSHAW ENTREPRENEURIAL ACADEMY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIA LOPEZ (CEO)
(424) 450-7412
Entity
Organization
Contact information
Practice address
5125 CRENSHAW BLVD, LOS ANGELES, CA 90043-1853
(424) 450-7412
Mailing address
206 W 1ST ST UNIT 101, SAN PEDRO, CA 90731-2806
(424) 450-7412
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
08/14/2022
Last updated
08/14/2022
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