| Pride Health Services Crenshaw | |
|
8619 Crenshaw Blvd Inglewood CA 90305-2330 | |
| (310) 766-9019 | |
| (310) 677-9401 |
| Full Name | Pride Health Services Crenshaw |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 8619 Crenshaw Blvd, Inglewood, California |
| Authorized Official Name and Position | Godfrey Nwogene (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3106779091 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pride Health Services Crenshaw 8619 Crenshaw Blvd Inglewood CA 90305-2330 Ph: (310) 766-9019 | Pride Health Services Crenshaw 8619 Crenshaw Blvd Inglewood CA 90305-2330 Ph: (310) 766-9019 |
| NPI Number | 1982822995 |
|---|---|
| Provider Enumeration Date | 04/23/2007 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982822995 | NPI | - | NPPES |
| 701231 | Other | CA | DRUG MEDI-CAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (California) | Primary |
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