Organization
MITCHLOCK FOUNDATION
Active
Other names
n/a
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES LOCKETT (OWNER)
(323) 251-4116
Entity
Organization
Contact information
Practice address
9061 S NORMANDIE AVE, LOS ANGELES, CA 90044-2051
(323) 251-4116
Mailing address
10018 S VAN NESS AVE APT 6, LOS ANGELES, CA 90047-4145
(323) 251-4116
Taxonomy
Speciality
Code
Description
License number
State
177F00000X
Lodging Provider
—
—
251V00000X
Voluntary or Charitable Agency
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
10/03/2023
Last updated
10/03/2023
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