| NPI | 1528515152 |
|---|---|
| Doing Business As | JWCH MEDICAL CLINIC - COVENANT HOUSE CALIFORNIA |
| Entity Type | Organization |
| Authorized Contact | ALVARO P. BALLESTEROS Chief Executive Officer 323-201-4516 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2016-09-01 |