Organization
MJB TRANSITIONAL RECOVERY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DARRELL NELMS BA (EXECUTIVE DIRECTOR)
(323) 777-2491
Entity
Organization
Contact information
Practice address
11152 S MAIN ST, LOS ANGELES, CA 90061-1953
(323) 777-2491
Mailing address
11152 S MAIN ST, LOS ANGELES, CA 90061-1953
(323) 777-2491
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
190288BN
CA
Other
Enumeration date
07/20/2016
Last updated
07/20/2016
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