Organization
LAVELLE YOUTH HOMES
Active
Organization
LAVELLE YOUTH HOMES
Active
Other names
The Lavelle Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TRACI LAVELLE (PRESIDENT AND CEO)
(310) 677-2569
Entity
Organization
Contact information
Practice address
652 E MANCHESTER BLVD, INGLEWOOD, CA 90301-1910
(310) 677-2569
(310) 677-9429
Mailing address
652 E MANCHESTER BLVD, INGLEWOOD, CA 90301-1910
(310) 677-2569
(310) 677-9429
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7132
MEDI-CAL PROVIDER NUMBER
CA
Enumeration date
03/21/2007
Last updated
05/07/2013
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