| Boyle Heights Satellite #2 | |
|
1624 S Hope St Los Angeles CA 90015-4119 | |
| (323) 262-1786 | |
| (323) 262-2659 |
| Full Name | Boyle Heights Satellite #2 |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1624 S Hope St, Los Angeles, California |
| Authorized Official Name and Position | Henry Van Oudheusden (PRESIDENT/CEO) |
| Authorized Official Contact | 3106799126 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Boyle Heights Satellite #2 15519 Crenshaw Blvd Gardena CA 90249-4525 Ph: (310) 679-9126 | Boyle Heights Satellite #2 1624 S Hope St Los Angeles CA 90015-4119 Ph: (323) 262-1786 |
| NPI Number | 1417218678 |
|---|---|
| Provider Enumeration Date | 06/05/2012 |
| Last Update Date | 06/05/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417218678 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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