| NPI | 1598216707 |
|---|---|
| Other Name | FRED JEFFERSON MEMORIAL HOME #2 |
| Entity Type | Organization |
| Authorized Contact | NIQUELLE LEWIS Cto/Program Director 310-763-1660 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Enumeration Date | 2016-10-24 |
| Last Update Date | 2020-03-03 |