Organization
CANON HUMAN SERVICES CENTERS, INC,
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD OLIVER HARRISON (EXECUTIVE DIRECTOR)
(323) 249-9097
Entity
Organization
Contact information
Practice address
5318-5320 S. BROADWAY, LOS ANGELES, CA 90037-3808
(323) 249-9097
(323) 249-9121
Mailing address
9705 HOLMES AVE, LOS ANGELES, CA 90002-3031
(323) 249-9097
(323) 249-9121
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
190099DN
CA
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
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Other
Enumeration date
02/20/2015
Last updated
06/02/2021
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