| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 8803 S 8th Ave, Inglewood, California |
| Authorized Official Name and Position | Samuel Chinenye Godwin (NP) |
| Authorized Official Contact | 3233479220 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
8803 S 8th Ave Inglewood CA 90305 Ph: (323) 347-9220 | 8803 S 8th Ave Inglewood CA 90305 Ph: (323) 347-9220 |
| NPI Number | 1972365237 |
|---|---|
| Provider Enumeration Date | 01/23/2024 |
| Last Update Date | 04/15/2024 |
| Certification Date | 04/15/2024 |
| Medicare PECOS PAC ID | 2365889664 |
|---|---|
| Medicare Enrollment ID | O20240322000122 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972365237 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Samuel C Godwin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699305839 PECOS PAC ID: 3274970579 Enrollment ID: I20240322000185 |
Soul Care Licensed Clinical Social Worker Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1316 Centinela Ave, Inglewood, CA 90302 Phone: 424-321-7685 | |
Jikole Helping Hands Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 317 E Hillcrest Blvd, Inglewood, CA 90301 Phone: 310-292-9941 | |
California Neuromedical Services Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 301 N Prairie Ave, Ste.315, Inglewood, CA 90301 Phone: 310-680-0304 Fax: 310-680-0305 | |
Maat Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3500 W Manchester Blvd Unit 349, Inglewood, CA 90305 Phone: 323-855-7527 |