| Enki Lpvmhc-la Puente | |
|
160 S 7th Ave La Puente CA 91746-3211 | |
| (626) 961-8971 | |
| (626) 961-6685 |
| Full Name | Enki Lpvmhc-la Puente |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 160 S 7th Ave, La Puente, California |
| Authorized Official Name and Position | Carl W. Urmer (PRESIDENT, C.O.O) |
| Authorized Official Contact | 8189734899 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Enki Lpvmhc-la Puente 150 E Olive Ave 203 Burbank CA 91502-1846 Ph: (818) 973-4899 | Enki Lpvmhc-la Puente 160 S 7th Ave La Puente CA 91746-3211 Ph: (626) 961-8971 |
| NPI Number | 1881725117 |
|---|---|
| Provider Enumeration Date | 03/08/2007 |
| Last Update Date | 06/01/2020 |
| Certification Date | 06/01/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881725117 | NPI | - | NPPES |
| 000007173 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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