Organization
LOS ANGELES WINGS OF FAITH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY C JACKSON (CEO)
(323) 833-2719
Entity
Organization
Contact information
Practice address
9626 AVALON BLVD, LOS ANGELES, CA 90003-4311
(323) 833-9719
(323) 779-6495
Mailing address
9626 AVALON BLVD, LOS ANGELES, CA 90003-4311
(323) 833-9719
(323) 779-6495
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
04/11/2007
Last updated
08/22/2020
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