Organization
KLEAN START, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RUDOLPH WASHINGTON MPA (EXECUTIVE DIRECTOR)
(310) 751-0821
Entity
Organization
Contact information
Practice address
2606 N CENTRAL AVE, COMPTON, CA 90222-1640
(310) 751-0821
Mailing address
3545 W LUTHER LN, INGLEWOOD, CA 90305-1886
(310) 337-1292
Taxonomy
Speciality
Code
Description
License number
State
101YS0200X
School Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
197483
DRUG MEDICAL
CA
Enumeration date
03/29/2012
Last updated
03/29/2012
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