| Shields For Families | |
|
2620 Industry Way Ste A, F Lynwood CA 90262-4042 | |
| (323) 242-5000 | |
| (323) 242-5011 |
| Full Name | Shields For Families |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2620 Industry Way Ste A, F, Lynwood, California |
| Authorized Official Name and Position | Kathryn Icenhower (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3232425000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shields For Families 11601 S Western Ave Los Angeles CA 90047-5006 Ph: (323) 242-5000 | Shields For Families 2620 Industry Way Ste A, F Lynwood CA 90262-4042 Ph: (323) 242-5000 |
| NPI Number | 1003041591 |
|---|---|
| Provider Enumeration Date | 05/27/2009 |
| Last Update Date | 08/12/2020 |
| Certification Date | 08/12/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003041591 | NPI | - | NPPES |
| 7764 | Other | CA | DRUG MEDI-CAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (California) | Primary |
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