| Re. Awakened Faith Community Services Llc | |
|
1516 E. 125th St Compton CA 90222-1004 | |
| (800) 936-0012 | |
| Not Available |
| Full Name | Re. Awakened Faith Community Services Llc |
|---|---|
| Speciality | Clinic/center - Community Health |
| Location | 1516 E. 125th St, Compton, California |
| Authorized Official Name and Position | Tanya L Lawrence (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3232394880 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Re. Awakened Faith Community Services Llc P.o. Box 5023 Compton CA 90224-5023 Ph: (800) 936-0012 | Re. Awakened Faith Community Services Llc 1516 E. 125th St Compton CA 90222-1004 Ph: (800) 936-0012 |
| NPI Number | 1609453539 |
|---|---|
| Provider Enumeration Date | 03/26/2021 |
| Last Update Date | 03/26/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609453539 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Primary |
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County Of Los Angeles Auditor Controller Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1108 N Oleander Ave, Compton, CA 90222 Phone: 310-763-2244 | |
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