| Soul Care Licensed Clinical Social Worker Inc. | |
|
1316 Centinela Ave Inglewood CA 90302-1140 | |
| (424) 321-7685 | |
| Not Available |
| Full Name | Soul Care Licensed Clinical Social Worker Inc. |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1316 Centinela Ave, Inglewood, California |
| Authorized Official Name and Position | Latanya Tolan (CEO) |
| Authorized Official Contact | 8008231772 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Soul Care Licensed Clinical Social Worker Inc. 4859 W Slauson Ave # 116 Los Angeles CA 90056-1290 Ph: (800) 823-1772 | Soul Care Licensed Clinical Social Worker Inc. 1316 Centinela Ave Inglewood CA 90302-1140 Ph: (424) 321-7685 |
| NPI Number | 1023608098 |
|---|---|
| Provider Enumeration Date | 01/22/2021 |
| Last Update Date | 01/22/2021 |
| Certification Date | 01/22/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023608098 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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