Organization
JWCH INSTITUTE, INC
Active
Parent organization
JWCH INSTITUTE, INC.
Other names
Center for Community Health
Organization subpart
Yes
Provider details
NPI number
Legal business name
JWCH INSTITUTE, INC.
Authorized official
ALVARO P. BALLESTEROS (CHIEF EXECUTIVE OFFICER)
(323) 201-4516
Entity
Organization
Contact information
Practice address
522 S SAN PEDRO ST, LOS ANGELES, CA 90013-2102
(213) 622-2639
(213) 624-8738
Mailing address
5650 JILLSON ST, COMMERCE, COMMERCE, CA 90040-1482
(323) 201-4516
(323) 215-0171
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
950001280
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CMM70900F
—
CA
Enumeration date
12/07/2007
Last updated
11/13/2014
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