Basic Information
| Provider Information | |||||||||
| NPI: | 1891810560 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BERNIE'S LIL WOMEN CENTER INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 942 E 116TH ST | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900591602 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2132801012 | ||||||||
| FaxNumber: | 3235637087 | ||||||||
| Practice Location | |||||||||
| Address1: | 11905 S CENTRAL AVE | ||||||||
| Address2: | SUITE 205 | ||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900592836 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3232499026 | ||||||||
| FaxNumber: | 3235637087 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/20/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | GOUDEAU | ||||||||
| AuthorizedOfficialFirstName: | BERNADINE | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 2132801012 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 324500000X | 190472BN | CA | Y | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility |
No ID Information.