| Ghc Of Mlk Llc | |
|
12021 Wilmington Ave, Bldg 18, Pod 5a Los Angeles CA 90059 | |
| (714) 241-5600 | |
| Not Available |
| Full Name | Ghc Of Mlk Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 12021 Wilmington Ave, Bldg 18, Pod 5a, Los Angeles, California |
| Authorized Official Name and Position | Lois Mastrocola (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 7142415600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ghc Of Mlk Llc 6 Hutton Centre Dr Ste 400 Santa Ana CA 92707-8762 Ph: (714) 241-5600 | Ghc Of Mlk Llc 12021 Wilmington Ave, Bldg 18, Pod 5a Los Angeles CA 90059 Ph: (714) 241-5600 |
| NPI Number | 1477377349 |
|---|---|
| Provider Enumeration Date | 11/08/2024 |
| Last Update Date | 11/08/2024 |
| Certification Date | 11/08/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477377349 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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