| Specialized Foster Care Carson | |
|
1 Civic Plaza Dr Carson CA 90745-2243 | |
| (310) 668-6925 | |
| (310) 898-1607 |
| Full Name | Specialized Foster Care Carson |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1 Civic Plaza Dr, Carson, 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 |
|---|---|
| Specialized Foster Care Carson 510 S Vermont Ave Los Angeles CA 90020-1992 Ph: (213) 738-4601 | Specialized Foster Care Carson 1 Civic Plaza Dr Carson CA 90745-2243 Ph: (310) 668-6925 |
| NPI Number | 1427603950 |
|---|---|
| Provider Enumeration Date | 08/01/2019 |
| Last Update Date | 09/12/2022 |
| Certification Date | 09/12/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427603950 | NPI | - | NPPES |
| 19C5 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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