JACK R WAITES

LOS ANGELES, CA
NPI1407629777
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2023-10-30
Last Update Date2023-10-30
Business Address
Mr. JACK R WAITES
155 BIMINI PL
LOS ANGELES, CA 90004-5902
Phone number: 213-388-5423
Mailing Address
Mr. JACK R WAITES
155 BIMINI PL
LOS ANGELES, CA 90004-5902
Phone number: 213-388-5423
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