Organization
ST. JOHNS COMMUNITY HEALTH
Active
Other names
St. John's Well Child and Family Center - Boys and Girls, St. John's Well Child and Family Center, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA SOCORRO GENIE (EXECUTIVE PROJECT DIRECTOR)
(323) 541-1600
Entity
Organization
Contact information
Practice address
1000 W. 50TH ST, LOS ANGELES, CA 90037
(323) 541-1411
(323) 541-1661
Mailing address
808 W 58TH ST, LOS ANGELES, CA 90037-3632
(323) 541-1600
(323) 541-1661
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1861893844
—
CA
Enumeration date
03/19/2018
Last updated
02/13/2024
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