KENLI T BLACK

GARDENA, CA
NPI1548012297
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy172V00000X Community Health Worker
Enumeration Date2024-04-04
Last Update Date2024-04-04
Business Address
KENLI T BLACK community peer
1225 W 190TH ST STE 280
GARDENA, CA 90248-4305
Phone number: 877-515-8113
Mailing Address
KENLI T BLACK community peer
1729 1/2 W ADAMS BLVD
LOS ANGELES, CA 90018-2702
Phone number: 916-730-6253