Basic Information
| Provider Information | |||||||||
| NPI: | 1760568489 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | COMPTON METAL HEALTH CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1833 N KINGSLEY DR APT 10 | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900273790 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2134796118 | ||||||||
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| Practice Location | |||||||||
| Address1: | 921 E COMPTON BLVD FL 1 | ||||||||
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| City: | COMPTON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902213303 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3106686800 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/27/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | ROBLES MONCADA | ||||||||
| AuthorizedOfficialFirstName: | HECTOR | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | PSYCHIATRIC SOCIAL WORKER | ||||||||
| AuthorizedOfficialTelephone: | 3106686800 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MSW | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM0801X | ASW 18369 | CA | X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) | 273R00000X | ASW 18369 | CA | X | Hospital Units | Psychiatric Unit |
No ID Information.