Organization
ANGEL WINGS RECOVERY OF SOUTH BAY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHIL COOKES (CEO)
(310) 863-7446
Entity
Organization
Contact information
Practice address
3841 W 130TH ST, HAWTHORNE, CA 90250-5311
(310) 863-7446
Mailing address
3841 W 130TH ST, HAWTHORNE, CA 90250-5311
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
190849BN
CA
Other
Enumeration date
06/16/2016
Last updated
06/16/2016
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