Organization
BIENVENIDOS HEALTHY START COMMUNITY CLINIC AT WILSON HIGH SCHOOL
Active
Parent organization
BIENVENIDOS CHILDREN'S CENTER, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
BIENVENIDOS CHILDREN'S CENTER, INC.
Authorized official
JACOBUS VAN DER COLFF (CHIEF FINANCIAL OFFICER)
(213) 785-5923
Entity
Organization
Contact information
Practice address
4500 MULTNOMAH ST, LOS ANGELES, CA 90032-3703
(323) 222-0970
(323) 222-0878
Mailing address
316 W 2ND ST, SUITE 800, LOS ANGELES, CA 90012-3504
(213) 785-5906
(213) 785-5914
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
960001182
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00343513
CLR
CA
01
—
05D2050805
CLIA
CA
Enumeration date
06/05/2013
Last updated
06/06/2013
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