| St. Joseph Center | |
|
204 Hampton Dr Venice CA 90291-2623 | |
| (310) 396-6468 | |
| (310) 392-8402 |
| Full Name | St. Joseph Center |
|---|---|
| Speciality | Case Management |
| Location | 204 Hampton Dr, Venice, California |
| Authorized Official Name and Position | Va Lecia Adams Kellum (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3103966468 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| St. Joseph Center 204 Hampton Dr Venice CA 90291-2623 Ph: (310) 396-6468 | St. Joseph Center 204 Hampton Dr Venice CA 90291-2623 Ph: (310) 396-6468 |
| NPI Number | 1952439093 |
|---|---|
| Provider Enumeration Date | 03/01/2007 |
| Last Update Date | 02/03/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952439093 | NPI | - | NPPES |
| 7114 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 251B00000X | Case Management | (* (Not Available)) | Primary |
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