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Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. LEN LOVALLO (JOBCOACHVOCATIONALTEAM LEADER)
(310) 420-5653
Entity
Organization

Contact information

Practice address
1328 2ND ST, SANTA MONICA, CA 90401-1122
(310) 420-5653
Mailing address
1328 2ND ST, SANTA MONICA, CA 90401-1122
(310) 420-5653

Taxonomy

Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
171M00000X
CA

Other

Enumeration date
06/27/2007
Last updated
08/07/2008
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