St. Johns Community Health
Clinic/Center, Community Health in Los Angeles, CA. Organization (NPI-2).
NPI number1417469495
StatusActive
Last updated in NPPESNov 9, 2023
Details
- NPI
- 1417469495
- Entity type
- Organization (NPI-2)
- Legal business name
- St. Johns Community Health
- Organization subpart
- No
- Enumeration date
- Oct 30, 2017
- Certification date
- Nov 9, 2023
- Last updated
- Nov 9, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QC1500X | Clinic/Center, Community Health | – | – | Yes |
| 171M00000X | Case Manager/Care Coordinator | – | – | |
| 171W00000X | Contractor | – | – | |
| 251B00000X | Case Management | – | – | |
| 251X00000X | Supports Brokerage | – | – |
Other names
- St. John'S Well Child And Family Center, INC. (Former Legal Business Name)
Practice location
4251 Crenshaw BlvdLos Angeles, CA 90008-2536
Phone 323-541-1600 · Fax 323-541-1661
Mailing address
808 W 58th StLos Angeles, CA 90037-3632
Phone 323-541-1600 · Fax 323-541-1661
Authorized official
James Mangia
President & Ceo
3235411601
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