Organization
AVIVA CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DINORA BEATRIZ MENA LVN (LICENSE VOCATIONAL NURSE)
(323) 876-0550
Entity
Organization
Contact information
Practice address
1701 CAMINO PALMERO ST, LOS ANGELES, CA 90046-2902
(323) 876-0550
Mailing address
1701 CAMINO PALMERO ST, LOS ANGELES, CA 90046-2902
(323) 876-0550
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
VN 266328
CA
Other
Enumeration date
04/22/2013
Last updated
04/22/2013
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