Organization
GENESIS LA TRANSPORTATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY ANN ROQUE (OWNER)
(310) 658-0436
Entity
Organization
Contact information
Practice address
26201 OZONE AVENUE, HARBOR CITY, CA 90710
(562) 449-3878
Mailing address
8605 SANTA MONICA BLVD # 273305, WEST HOLLYWOOD, CA 90069-4109
(562) 449-3878
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
01/17/2024
Last updated
05/28/2024
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