Organization
LOS ANGELES TEEN OUTPATIENT CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY SCHOSER (REVENUE CYCLE MANAGER)
(323) 364-6489
Entity
Organization
Contact information
Practice address
5150 WILSHIRE BLVD STE 300, LOS ANGELES, CA 90036-4436
(323) 364-6489
Mailing address
6053 BRISTOL PKWY, CULVER CITY, CA 90230-6601
(323) 364-6489
(310) 919-0372
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
10/20/2021
Last updated
10/20/2021
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