Organization
FRED JEFFERSON MEMORIAL HOME FOR BOYS
Active
Other names
Fred Jefferson Memorial Home #2
Organization subpart
No
Provider details
NPI number
Authorized official
NIQUELLE LEWIS (CTO/PROGRAM DIRECTOR)
(310) 763-1660
Entity
Organization
Contact information
Practice address
1448 E 142ND ST, COMPTON, CA 90222-3702
(310) 604-0595
(310) 604-1357
Mailing address
1448 E 142ND ST, COMPTON, CA 90222-3702
(310) 766-1660
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
10/24/2016
Last updated
03/03/2020
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