| L. A.south Health Servies | |
|
1704 W Manchester Ave Suite 205 Los Angeles CA 90047-3034 | |
| (323) 751-0608 | |
| (323) 751-0375 |
| Full Name | L. A.south Health Servies |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1704 W Manchester Ave, Los Angeles, California |
| Authorized Official Name and Position | Matthew E Etuk (EXCUTUVE DIRECTOR) |
| Authorized Official Contact | 3237510608 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| L. A.south Health Servies 1704 W Manchester Ave Suite 205 Los Angeles CA 90047-3034 Ph: (323) 751-0608 | L. A.south Health Servies 1704 W Manchester Ave Suite 205 Los Angeles CA 90047-3034 Ph: (323) 751-0608 |
| NPI Number | 1922131549 |
|---|---|
| Provider Enumeration Date | 03/13/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922131549 | NPI | - | NPPES |
| 190476AN | Other | CA | DRUG REHABILITATION CLINI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 190476AN (California) | Primary |
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