Healthcare Provider Details

I. General information

NPI: 1184587966
Provider Name (Legal Business Name): SS.INTERNATIONAL COMMUNITY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 11/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 W 57TH ST
LOS ANGELES CA
90037-4113
US

IV. Provider business mailing address

155 W 57TH ST
LOS ANGELES CA
90037-4113
US

V. Phone/Fax

Practice location:
  • Phone: 213-766-5712
  • Fax:
Mailing address:
  • Phone: 213-766-5712
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name: SAMARA L MILLER
Title or Position: PROGRAM DIRECTOR/COMMUNITY HEALTH W
Credential:
Phone: 213-431-2364