Healthcare Provider Details

I. General information

NPI: 1174743579
Provider Name (Legal Business Name): ARMS OF GRACE HUMANITARIAN SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2931 W FLORENCE AVE
LOS ANGELES CA
90043-5110
US

IV. Provider business mailing address

2931 W FLORENCE AVE
LOS ANGELES CA
90043-5110
US

V. Phone/Fax

Practice location:
  • Phone: 323-750-8040
  • Fax: 323-750-8075
Mailing address:
  • Phone: 323-750-8040
  • Fax: 323-750-8075

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateCA

VIII. Authorized Official

Name: MS. ANNETTE L SCOTT
Title or Position: PROGRAM COORDINATOR
Credential:
Phone: 323-750-8040