Organization
ST. JOHNS COMMUNITY HEALTH
Active
Other names
St. John's Well Child and Family Center, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES MANGIA (PRESIDENT & CEO)
(323) 541-1601
Entity
Organization
Contact information
Practice address
4251 CRENSHAW BLVD, LOS ANGELES, CA 90008-2536
(323) 541-1600
(323) 541-1661
Mailing address
808 W 58TH ST, LOS ANGELES, CA 90037-3632
(323) 541-1600
(323) 541-1661
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
171W00000X
Contractor
—
—
251B00000X
Case Management Agency
—
—
251X00000X
Supports Brokerage Agency
—
—
261QC1500X
Community Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1861893844
—
CA
Enumeration date
10/30/2017
Last updated
11/09/2023
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