| NPI | 1629947502 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALVARO PROSPERO BALLESTEROS Chief Executive Officer 323-201-4516 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 251X00000X Supports Brokerage | |
| Enumeration Date | 2025-10-30 |
| Last Update Date | 2025-10-30 |