Organization
COVENANT HOUSE CALIFORNIA
Active
Parent organization
COVENANT HOUSE
Other names
Children's Hospital La Covenant
Organization subpart
Yes
Provider details
NPI number
Legal business name
COVENANT HOUSE
Authorized official
MR. BILL BEDROSSIAN MSW (EXECUTIVE DIRECTOR)
(323) 461-3131
Entity
Organization
Contact information
Practice address
1325 N WESTERN AVE, LOS ANGELES, CA 90027-5615
(323) 461-3131
(323) 957-7419
Mailing address
1325 N WESTERN AVE, LOS ANGELES, CA 90027-5615
(323) 461-3131
(323) 957-6491
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
06/04/2007
Last updated
01/30/2017
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