| NPI | 1578840799 |
|---|---|
| Doing Business As | CRENSHAW NEW LIFE COMMUNITY CENTER |
| Entity Type | Organization |
| Authorized Contact | ROBBIE LENOX Executive Director 323-702-3543 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization |
| Enumeration Date | 2011-11-16 |
| Last Update Date | 2011-11-16 |