Healthcare Provider Details

I. General information

NPI: 1821132317
Provider Name (Legal Business Name): ASPIRA FOSTER & FAMILY SERVICES - LOS ANGELES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2007
Last Update Date: 08/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5730 UPLANDER WAY SUITE 202
CULVER CITY CA
90230-6617
US

IV. Provider business mailing address

5730 UPLANDER WAY SUITE 202
CULVER CITY CA
90230-6617
US

V. Phone/Fax

Practice location:
  • Phone: 310-410-5180
  • Fax: 310-410-5188
Mailing address:
  • Phone: 310-410-5180
  • Fax: 310-410-5188

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateCA

VIII. Authorized Official

Name: MR. VERNON BROWN
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 650-866-4080