Organization · NPI-2

County Of Los Angeles Department Of Mental Health

Point of Service · Los Angeles, CA

NPI number1114331139
StatusActive
Last updated in NPPESJun 18, 2014

Details

NPI
1114331139
Entity type
Organization (NPI-2)
Legal business name
County Of Los Angeles Department Of Mental Health
Organization subpart
Yes
Enumeration date
Jun 18, 2014
Last updated
Jun 18, 2014

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
305S00000X Point of Service–CAYes

Other names

  • Central Juvenile Hall Mental Health Unit (Former Legal Business Name)

Practice location

1605 Eastlake Ave
2nd Floor
Los Angeles, CA 90033-1009

Phone 323-226-8826 · Fax 323-226-8820

Mailing address

1605 Eastlake Avenue
2nd Floor
Los Angeles, CA 90033

Phone 323-226-8826 · Fax 323-226-8820

Authorized official

Marvin J Southard, D.S.W.
Director
2137384601

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