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NPI Code Detail

MEDICARE: OPEN ARMS MENS CENTER

MEDICARE: OPEN ARMS MENS CENTER
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
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1932340130
Entity Type Code : Organization
Provider Name (Legal Business Name) : OPEN ARMS MENS CENTER
Provider Business Mailing Address
First Line : 8306 WILSHIRE BLVD
Second Line : # 7024
City : BEVERLY HILLS
State : CA
Zip : 90211
Country : US
Telephone Number : 323-755-2742
Fax Number : 310-876-0533
Provider Business Practice Location Address
First Line : 1339 E. 120TH ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90059
Country : US
Telephone Number : 323-755-2742
Fax Number :
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : RHONDA LABOMME
Credential :
Telephone Number : 323-755-2742
Provider Enumeration Date : 03/18/2009
Last Update Date : 03/18/2009

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Directions to “OPEN ARMS MENS CENTER ” Practice Location

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