| Queenscare Family Clinics - Mental Health | |
|
1300 N Vermont Ave Suite 809 Los Angeles CA 90027-6005 | |
| (323) 669-4355 | |
| Not Available |
| Full Name | Queenscare Family Clinics - Mental Health |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1300 N Vermont Ave, Los Angeles, California |
| Authorized Official Name and Position | Terry Allen Bonecutter (PRESIDENT AND CEO) |
| Authorized Official Contact | 3236694303 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Queenscare Family Clinics - Mental Health 1300 N Vermont Ave Suite 809 Los Angeles CA 90027-6005 Ph: (323) 669-4355 | Queenscare Family Clinics - Mental Health 1300 N Vermont Ave Suite 809 Los Angeles CA 90027-6005 Ph: (323) 669-4355 |
| NPI Number | 1043476609 |
|---|---|
| Provider Enumeration Date | 08/04/2008 |
| Last Update Date | 08/04/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043476609 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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