Organization
TOTAL FAMILY SUPPORT CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARINA VERKHOVSKY MS (DIRECTOR OF HR)
(213) 213-0581
Entity
Organization
Contact information
Practice address
1618 W 184TH ST, GARDENA, CA 90248-3803
(213) 213-0581
(213) 213-0580
Mailing address
830 S OLIVE ST, LOS ANGELES, CA 90014-3006
(213) 213-0581
(213) 213-0580
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
251B00000X
Case Management Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
196834
—
CA
Enumeration date
08/25/2009
Last updated
06/24/2011
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