Organization
INTERCONNECTION CENTER INC.
Active
Other names
Grand Avenue Center For Dignity
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RUDY BUTLER (EXCUTIVE DIRECTOR)
(213) 747-4626
Entity
Organization
Contact information
Practice address
3833 S GRAND AVE, LOS ANGELES, CA 90037-1311
(213) 747-4626
Mailing address
3833 S GRAND AVE, LOS ANGELES, CA 90037-1311
(213) 747-4626
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
190383AN
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6893
SUBSTANCE ABUSE REHAB
CA
Enumeration date
04/23/2007
Last updated
08/22/2020
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