Healthcare Provider Details

I. General information

NPI: 1346402831
Provider Name (Legal Business Name): WB COMMUNITY LEARNING CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2008
Last Update Date: 06/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8443 CRENSHAW BLVD SUITE 103
INGLEWOOD CA
90305-1900
US

IV. Provider business mailing address

8443 CRENSHAW BLVD SUITE 103
INGLEWOOD CA
90305-1900
US

V. Phone/Fax

Practice location:
  • Phone: 323-778-7254
  • Fax: 323-777-1025
Mailing address:
  • Phone: 323-778-7254
  • Fax: 323-777-1025

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MISS LOIS MARIE LEBLANC
Title or Position: EXECUTIVE DIRECTOR
Credential: BA
Phone: 323-778-7254