Healthcare Provider Details

I. General information

NPI: 1750252268
Provider Name (Legal Business Name): HOUSING 1BY1
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2025
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1815 W 36TH ST
LOS ANGELES CA
90018-3814
US

IV. Provider business mailing address

15402 GRAMERCY PL
GARDENA CA
90249-4713
US

V. Phone/Fax

Practice location:
  • Phone: 310-568-0090
  • Fax:
Mailing address:
  • Phone: 310-568-0090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code177F00000X
TaxonomyLodging Provider
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: DEJON DIXON
Title or Position: OWNER
Credential:
Phone: 323-316-0026