MEDICARE: VOLUNTEERS OF AMERICA OF 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
1	324500000X	Substance Abuse Rehabilitation Facility	190027AN	CA

General Provider Information

NPI Number	:	1659733327
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VOLUNTEERS OF AMERICA OF LOS ANGELES

Provider Business Mailing Address
First Line	:	3600 WILSHIRE BLVD
Second Line	:	SUITE 1500
City	:	LOS ANGELES
State	:	CA
Zip	:	90010-2603
Country	:	US
Telephone Number	:	213-389-1500
Fax Number	:	213-383-2493

Provider Business Practice Location Address
First Line	:	4969 W SUNSET BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-5813
Country	:	US
Telephone Number	:	213-389-1500
Fax Number	:	213-383-2493

Authorized Official
Title or Position	:	INTERNAL LEGAL COUNSEL
Name	:	CANEEL C. FRASER
Credential	:	ESQ.
Telephone Number	:	213-251-7698

Provider Enumeration Date	:	03/22/2016
Last Update Date	:	03/22/2016

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