| Lincoln Heights Family Recovery Ctr | |
|
4099 N Mission Rd Los Angeles CA 90032-2554 | |
| (323) 221-1746 | |
| (323) 221-5176 |
| Full Name | Lincoln Heights Family Recovery Ctr |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 4099 N Mission Rd, Los Angeles, California |
| Authorized Official Name and Position | Henry Van Oudheusden (PRESIDENT/CEO) |
| Authorized Official Contact | 3106799126 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lincoln Heights Family Recovery Ctr 15519 Crenshaw Blvd Gardena CA 90249-4525 Ph: (310) 679-9126 | Lincoln Heights Family Recovery Ctr 4099 N Mission Rd Los Angeles CA 90032-2554 Ph: (323) 221-1746 |
| NPI Number | 1073641478 |
|---|---|
| Provider Enumeration Date | 02/28/2007 |
| Last Update Date | 02/27/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073641478 | NPI | - | NPPES |
| 190007KN | Medicaid | CA | |
| 7520 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 190007KN (California) | Primary |
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