Shields For Families | |
2620 Industry Way Ste E-f Lynwood CA 90262-4024 | |
(323) 242-5000 | |
(323) 242-5011 |
Full Name | Shields For Families |
---|---|
Speciality | Community/behavioral Health |
Location | 2620 Industry Way Ste E-f, Lynwood, California |
Authorized Official Name and Position | Kathryn Icenhower (CHIEF EXECUTIVE OFFICER) |
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: () - | Shields For Families 2620 Industry Way Ste E-f Lynwood CA 90262-4024 Ph: (323) 242-5000 |
NPI Number | 1376778860 |
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Provider Enumeration Date | 05/27/2009 |
Last Update Date | 04/10/2020 |
Certification Date | 04/10/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1376778860 | NPI | - | NPPES |
197389 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (California) | Primary |
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