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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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