| Dmh- Central Juvenile Hall | |
|
1605 Eastlake Ave Los Angeles CA 90033-1009 | |
| (323) 226-8847 | |
| Not Available |
| Full Name | Dmh- Central Juvenile Hall |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1605 Eastlake Ave, Los Angeles, California |
| Authorized Official Name and Position | Diana Lujan (PSYCHIATRIC SOCIAL WORK INTERN) |
| Authorized Official Contact | 3239192878 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dmh- Central Juvenile Hall 1605 Eastlake Ave Los Angeles CA 90033-1009 Ph: (323) 226-8847 | Dmh- Central Juvenile Hall 1605 Eastlake Ave Los Angeles CA 90033-1009 Ph: (323) 226-8847 |
| NPI Number | 1982955407 |
|---|---|
| Provider Enumeration Date | 09/24/2012 |
| Last Update Date | 09/24/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982955407 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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