Organization · NPI-2

Gateways Percy Village

Psychiatric Residential Treatment Facility · Los Angeles, CA

NPI number1215066436
StatusActive
Last updated in NPPESMar 11, 2015

Details

NPI
1215066436
Entity type
Organization (NPI-2)
Legal business name
Gateways Percy Village
Organization subpart
No
Enumeration date
Mar 5, 2007
Last updated
Mar 11, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
323P00000X Psychiatric Residential Treatment Facility198600612CAYes

Practice location

3455 Percy Street
Los Angeles, CA 90023

Phone 323-268-2100 · Fax 323-268-2460

Mailing address

1891 Effie Street
Los Angeles, CA 90026

Phone 323-268-2100

Authorized official

Mara Pelsman
Ceo
3236442000

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