| NPI | 1386708634 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALVARO P. BALLESTEROS Chief Executive Officer 323-201-4516 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) (Licence: CA 550000250) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 251X00000X Supports Brokerage | |
| 261Q00000X Clinic/Center (Licence: CA 550000250) | |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2022-02-01 |