Organization
DEPARTMENT OF MENTAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN GREEN LCSW (PRGRAM HEAD)
(213) 351-5369
Entity
Organization
Contact information
Practice address
550 S. VERMONT STREET 6TH FLOOR, LOS ANGELES, CA 90020-1912
(213) 351-5368
Mailing address
10785 WILKINS AVENUE, LOS ANGELES, CA 90024-5064
(310) 508-0404
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
24803
CA
Other
Enumeration date
08/30/2010
Last updated
08/30/2010
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