Healthcare Provider Details

I. General information

NPI: 1922765189
Provider Name (Legal Business Name): VOLUNTEERS OF AMERICA OF LOS ANGELES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/23/2021
Last Update Date: 06/16/2022
Certification Date: 06/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6816 AVALON BLVD
LOS ANGELES CA
90003-1922
US

IV. Provider business mailing address

3600 WILSHIRE BLVD STE 1500
LOS ANGELES CA
90010-2619
US

V. Phone/Fax

Practice location:
  • Phone: 714-615-8658
  • Fax:
Mailing address:
  • Phone: 213-389-1500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. JASPER DO
Title or Position: GRANT ADMINISTRATOR
Credential:
Phone: 213-251-7668