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
MRS. MARIA SOCORRO GENIE (EXECUTIVE PROJECT DIRECTOR)
(323) 541-1600
Entity
Organization
Contact information
Practice address
6818 AVALON BLVD., LOS ANGELES, CA 90003
(323) 541-1600
(323) 541-1683
Mailing address
808 W 58TH ST, LOS ANGELES, CA 90037-3632
(323) 541-1600
(323) 541-1683
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
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
11/30/2020
Last updated
02/13/2024
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