Organization
BENEVOLENCE INDUSTRIES INCORPORATED
Active
Parent organization
CRENSHAW COMMUNITY CLINIC
Organization subpart
Yes
Provider details
NPI number
Legal business name
CRENSHAW COMMUNITY CLINIC
Authorized official
KWABENA OBENG (CHIEF EXECUTIVE OFFICER)
(310) 800-7963
Entity
Organization
Contact information
Practice address
3631 CRENSHAW BLVD, 109, LOS ANGELES, CA 90016-4869
(323) 732-0100
(323) 732-0104
Mailing address
1010 CRENSHAW BLVD STE 100, TORRANCE, CA 90501-2055
(323) 732-0100
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
550001971
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1578763207
—
CA
Enumeration date
07/20/2007
Last updated
01/21/2021
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