Organization
JWCH INSTITUTE, INC.
Active
Other names
Wesley Health Centers Vermont Annex
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALVARO PROSPERO BALLESTEROS (CHIEF EXECUTIVE OFFICER)
(323) 201-4516
Entity
Organization
Contact information
Practice address
964 N VERMONT AVE, LOS ANGELES, CA 90029-3529
(323) 201-4516
Mailing address
5650 JILLSON ST, COMMERCE, CA 90040-1482
(323) 201-4516
(323) 215-0228
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
06/23/2020
Last updated
06/25/2020
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