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2320 W 149th St Gardena CA 90249-3702 | |
| (310) 217-9537 | |
| (310) 217-6117 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 2320 W 149th St, Gardena, California |
| Authorized Official Name and Position | Layne S. Wakuta (RECREATION THERAPIST) |
| Authorized Official Contact | 3102179552 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1670 W 162nd St Gardena CA 90247-3734 Ph: (310) 217-9552 | 2320 W 149th St Gardena CA 90249-3702 Ph: (310) 217-9537 |
| NPI Number | 1568652915 |
|---|---|
| Provider Enumeration Date | 07/31/2007 |
| Last Update Date | 12/11/2020 |
| Certification Date | 12/10/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568652915 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Sunshine Community Resource Organization Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1202 W 135th Street, Gardena, CA 90247 Phone: 626-600-9392 | |
City2village International Initiative Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 18726 S Western Ave Ste 403, Gardena, CA 90248 Phone: 310-769-5710 Fax: 844-850-5892 | |
Mendrix Medical Associates Inc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 18726 S Western Ave Ste 320, Gardena, CA 90248 Phone: 310-773-8975 Fax: 702-977-1496 | |