| Women's Community Re-entry Program | |
|
8300 South Vermont Avenue Los Angeles CA 90044-3422 | |
| (323) 525-6400 | |
| (323) 565-2133 |
| Full Name | Women's Community Re-entry Program |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 8300 South Vermont Avenue, 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 |
|---|---|
| Women's Community Re-entry Program 510 S Vermont Ave Los Angeles CA 90020-1992 Ph: (213) 738-4601 | Women's Community Re-entry Program 8300 South Vermont Avenue Los Angeles CA 90044-3422 Ph: (323) 525-6400 |
| NPI Number | 1477737534 |
|---|---|
| Provider Enumeration Date | 12/26/2007 |
| Last Update Date | 08/08/2022 |
| Certification Date | 08/08/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477737534 | NPI | - | NPPES |
| 7715 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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