Organization
COMPASSION CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY ALEXANDER LESTER JR. (VICE PRESIDENT)
(310) 230-5574
Entity
Organization
Contact information
Practice address
960 S SOTO ST, LOS ANGELES, CA 90023-1323
(310) 230-5574
(323) 373-9786
Mailing address
2614 CRENSHAW BLVD, LOS ANGELES, CA 90016-3057
(310) 230-5574
(323) 373-9786
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
19748
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7458
MEDI-CAL
CA
Enumeration date
01/14/2013
Last updated
01/14/2013
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