Organization
GRACELIGHT COMMUNITY HEALTH
Active
Other names
Queenscare Health Centers
Organization subpart
No
Provider details
NPI number
Authorized official
ELOISA PERARD (PRESIDENT & CEO)
(323) 669-4321
Entity
Organization
Contact information
Practice address
303 LOMA DR STE 202, LOS ANGELES, CA 90017-1103
(323) 635-1140
Mailing address
4816 E 3RD ST, LOS ANGELES, CA 90022-1602
(323) 780-4510
(323) 981-1662
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
08/06/2019
Last updated
06/27/2024
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