| Inglewood Alcohol And Drug Program | |
|
400 S La Brea Ave Suite 202 Inglewood CA 90301-2339 | |
| (310) 673-5882 | |
| (310) 673-5904 |
| Full Name | Inglewood Alcohol And Drug Program |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 400 S La Brea Ave, Inglewood, California |
| Authorized Official Name and Position | Gloria Mchenry Lewis (ADMINISTRATOR) |
| Authorized Official Contact | 3106735882 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Inglewood Alcohol And Drug Program 400 S La Brea Ave Suite 202 Inglewood CA 90301-2339 Ph: (310) 673-5882 | Inglewood Alcohol And Drug Program 400 S La Brea Ave Suite 202 Inglewood CA 90301-2339 Ph: (310) 673-5882 |
| NPI Number | 1750369039 |
|---|---|
| Provider Enumeration Date | 01/05/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750369039 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 19-041-01-100 (California) | Primary |
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