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NPI Code Detail

MEDICARE: HOMELESS HEALTH CARE LOS ANGELES

MEDICARE: HOMELESS HEALTH CARE LOS ANGELES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency190246ANCA

General Provider Information

NPI Number : 1467751800
Entity Type Code : Organization
Provider Name (Legal Business Name) : HOMELESS HEALTH CARE LOS ANGELES
Provider Business Mailing Address
First Line : 2330 BEVERLY BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90057-2220
Country : US
Telephone Number : 213-739-1627
Fax Number : 213-739-1617
Provider Business Practice Location Address
First Line : 2330 BEVERLY BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90057-2220
Country : US
Telephone Number : 213-739-1627
Fax Number : 213-739-1617
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MR. MARK CASANOVA
Credential : MA
Telephone Number : 213-739-1627
Provider Enumeration Date : 03/24/2011
Last Update Date : 03/24/2011

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Directions to “HOMELESS HEALTH CARE LOS ANGELES ” Practice Location

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