Healthcare Provider Details

I. General information

NPI: 1942337209
Provider Name (Legal Business Name): TRANSITIONAL LIVING CENTERS FOR LOS ANGELES COUNTY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15342 HAWTHORNE BLVD SUITE 102
LAWNDALE CA
90260-2152
US

IV. Provider business mailing address

16119 PRAIRIE AVE
LAWNDALE CA
90260-2714
US

V. Phone/Fax

Practice location:
  • Phone: 310-542-4825
  • Fax: 310-542-4552
Mailing address:
  • Phone: 310-542-4825
  • Fax: 310-542-4552

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. KENNETH PARKER
Title or Position: PRESIDENT
Credential: PH.D.
Phone: 310-542-4825