| Smart | |
|
100 W 1st St 6th Floor, Suite 630 Los Angeles CA 90012-4112 | |
| (213) 996-1343 | |
| (213) 996-1340 |
| Full Name | Smart |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 100 W 1st St, Los Angeles, 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 |
|---|---|
| Smart 510 S Vermont Ave Los Angeles CA 90020-1992 Ph: (213) 738-4601 | Smart 100 W 1st St 6th Floor, Suite 630 Los Angeles CA 90012-4112 Ph: (213) 996-1343 |
| NPI Number | 1164436598 |
|---|---|
| Provider Enumeration Date | 07/28/2006 |
| Last Update Date | 08/26/2022 |
| Certification Date | 08/26/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164436598 | NPI | - | NPPES |
| 7216 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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