Organization
CRISTIAN CENTER MANOR ALCOHOL AND DRUG BEHAVIOR CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILL THOMAS WASHINGTON (PRESIDENT)
(323) 751-3896
Entity
Organization
Contact information
Practice address
8721 S BROADWAY, LOS ANGELES, CA 90003-3321
(323) 752-3700
Mailing address
8721 S BROADWAY, LOS ANGELES, CA 90003-3321
(323) 752-3700
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
109445AN
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
190445AN
STATE CA, (AOD) ID #
CA
Enumeration date
10/16/2007
Last updated
10/17/2007
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