Organization
LAVELLE YOUTH HOMES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS TRACI LA VELLE (EXECUTIVE DIRECTOR)
(323) 759-2569
Entity
Organization
Contact information
Practice address
4000 W SLAUSON AVE, LOS ANGELES, CA 90043-2804
(323) 759-2569
Mailing address
8415 S WESTERN AVE, LOS ANGELES, CA 90047-3044
(323) 759-2569
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
03/25/2011
Last updated
03/25/2011
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