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301 N Prairie Ave Ste 511 Inglewood CA 90301-4512 | |
| (323) 291-5003 | |
| (323) 291-5007 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 301 N Prairie Ave Ste 511, Inglewood, California |
| Authorized Official Name and Position | Lucyna Iga Gaj (DIRECTOR FAMILY SERVICES) |
| Authorized Official Contact | 3232915003 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
301 N Prairie Ave Ste 511 Inglewood CA 90301-4512 Ph: (323) 291-5003 | 301 N Prairie Ave Ste 511 Inglewood CA 90301-4512 Ph: (323) 291-5003 |
| NPI Number | 1205207743 |
|---|---|
| Provider Enumeration Date | 10/09/2015 |
| Last Update Date | 04/27/2023 |
| Certification Date | 04/27/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205207743 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | MFC40850 (California) | Primary |
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