Healthcare Provider Details

I. General information

NPI: 1245519123
Provider Name (Legal Business Name): LA COUNTY MENTAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2011
Last Update Date: 08/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

921 E COMPTON BLVD
COMPTON CA
90221-3303
US

IV. Provider business mailing address

921 E COMPTON BLVD
COMPTON CA
90221-3303
US

V. Phone/Fax

Practice location:
  • Phone: 310-668-6800
  • Fax:
Mailing address:
  • Phone: 310-668-6800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number092155
License Number StateCA

VIII. Authorized Official

Name: ELENA FARIAS
Title or Position: DISTRICT CHIEF
Credential:
Phone: 310-668-6878