Organization
JWCH INSTITUTE, INC
Active
Organization
JWCH INSTITUTE, INC
Active
Other names
Wesley Health Centers - Cecil Hotel
Organization subpart
No
Provider details
NPI number
Authorized official
ALVARO PROSPERO BALLESTEROS (CHIEF EXECUTIVE OFFICER)
(323) 201-4516
Entity
Organization
Contact information
Practice address
640 S MAIN ST, LOS ANGELES, CA 90014-2004
(213) 947-3233
Mailing address
5650 JILLSON ST, COMMERCE, CA 90040-1482
(323) 201-4516
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251X00000X
Supports Brokerage Agency
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
10/10/2024
Last updated
10/10/2024
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