Organization
JWCH INSTITUTE, INC
Active
Other names
JWCH Medical Clinic - Covenant House California
Organization subpart
No
Provider details
NPI number
Authorized official
ALVARO P. BALLESTEROS (CHIEF EXECUTIVE OFFICER)
(323) 201-4516
Entity
Organization
Contact information
Practice address
1325 N WESTERN AVE, LOS ANGELES, CA 90027-5615
(323) 461-3131
(323) 957-7419
Mailing address
5650 JILLSON STREET, COMMERCE, CA 90040-1482
(323) 201-4516
(323) 215-0170
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
—
CA
Other
Enumeration date
09/01/2016
Last updated
09/01/2016
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