| Calworks Dmh Hq Admin | |
|
510 S Vermont Ave Fl 21 Los Angeles CA 90020-1912 | |
| (213) 639-6777 | |
| (213) 402-2934 |
| Full Name | Calworks Dmh Hq Admin |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 510 S Vermont Ave Fl 21, Los Angeles, California |
| Authorized Official Name and Position | Lisa H. Wong (DIRECTOR) |
| Authorized Official Contact | 2137384601 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Calworks Dmh Hq Admin 510 S Vermont Ave Los Angeles CA 90020-1992 Ph: (213) 738-4601 | Calworks Dmh Hq Admin 510 S Vermont Ave Fl 21 Los Angeles CA 90020-1912 Ph: (213) 639-6777 |
| NPI Number | 1285108415 |
|---|---|
| Provider Enumeration Date | 01/22/2019 |
| Last Update Date | 03/31/2023 |
| Certification Date | 03/31/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285108415 | NPI | - | NPPES |
| 19BJ | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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