KENLI T BLACK

GARDENA, CA
NPI1548012297
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy373H00000X Day Training/Habilitation Specialist
Additional Taxonomies172V00000X Community Health Worker
Enumeration Date2024-04-04
Last Update Date2025-07-16
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
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