Organization
JWCH INSTITUTE INC.
Active
Other names
JWCH PATH Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
ALVARO PROSPERO BALLESTEROS (CHIEF EXECUTIVE OFFICER)
(323) 201-4516
Entity
Organization
Contact information
Practice address
320 N MADISON AVE, LOS ANGELES, CA 90004-3779
(323) 644-2252
Mailing address
5650 JILLSON ST, COMMERCE, CA 90040-1482
(323) 201-4516
(323) 215-0170
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
05/21/2021
Last updated
05/21/2021
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