Organization
KLEAN START
Active
Organization
KLEAN START
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RUDOLPH WASHINGTON MPA (DIRECTOR)
(310) 751-0821
Entity
Organization
Contact information
Practice address
12501 S WILMINGTON AVE, COMPTON, CA 90222-1220
(310) 751-0821
Mailing address
3545 W LUTHER LN, INGLEWOOD, CA 90305-1886
(310) 337-1292
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
2518979
CA
Other
Enumeration date
02/03/2011
Last updated
09/19/2011
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