Hawthorne Specialized Fc Mhs | |
11539 Hawthorne Blvd Hawthorne CA 90250-2325 | |
(310) 263-2155 | |
Not Available |
Full Name | Hawthorne Specialized Fc Mhs |
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Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
Location | 11539 Hawthorne Blvd, Hawthorne, California |
Authorized Official Name and Position | Lisa H. Wong (ACTING DIRECTOR) |
Authorized Official Contact | 2137384601 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Hawthorne Specialized Fc Mhs 510 S Vermont Ave Los Angeles CA 90020-1992 Ph: (213) 738-4601 | Hawthorne Specialized Fc Mhs 11539 Hawthorne Blvd Hawthorne CA 90250-2325 Ph: (310) 263-2155 |
NPI Number | 1225046667 |
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Provider Enumeration Date | 08/03/2006 |
Last Update Date | 07/29/2022 |
Certification Date | 07/29/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1225046667 | NPI | - | NPPES |
7609 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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