Basic Information
| Provider Information | |||||||||
| NPI: | 1245519123 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | LA COUNTY MENTAL HEALTH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 921 E COMPTON BLVD | ||||||||
| Address2: | |||||||||
| City: | COMPTON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902213303 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3106686800 | ||||||||
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| Practice Location | |||||||||
| Address1: | 921 E COMPTON BLVD | ||||||||
| Address2: | |||||||||
| City: | COMPTON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902213303 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3106686800 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/10/2011 | ||||||||
| LastUpdateDate: | 08/10/2011 | ||||||||
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| AuthorizedOfficialLastName: | FARIAS | ||||||||
| AuthorizedOfficialFirstName: | ELENA | ||||||||
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| AuthorizedOfficialTitleorPosition: | DISTRICT CHIEF | ||||||||
| AuthorizedOfficialTelephone: | 3106686878 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251K00000X | N | Agencies | Public Health or Welfare | 101YA0400X | 092155 | CA | Y | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.