| Inglewood Community Recovery Center | |
|
404 Edgewood St Inglewood CA 90302-3415 | |
| (310) 673-5750 | |
| (310) 673-1236 |
| Full Name | Inglewood Community Recovery Center |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 404 Edgewood St, Inglewood, California |
| Authorized Official Name and Position | Teri Cannon (EXECUTIVE VICE PRESIDENT) |
| Authorized Official Contact | 3106799126 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Inglewood Community Recovery Center 15519 Crenshaw Blvd Gardena CA 90249-4525 Ph: (310) 679-9126 | Inglewood Community Recovery Center 404 Edgewood St Inglewood CA 90302-3415 Ph: (310) 673-5750 |
| NPI Number | 1912037797 |
|---|---|
| Provider Enumeration Date | 03/07/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912037797 | NPI | - | NPPES |
| 190007BN | Other | CA | ALCOHOL DRUG CERTIFICATIO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 190007BN (California) | Primary |
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