Healthcare Provider Details

I. General information

NPI: 1598678773
Provider Name (Legal Business Name): AWAKE.ORG
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5955 S WESTERN AVE
LOS ANGELES CA
90047-1124
US

IV. Provider business mailing address

PO BOX 2332
INGLEWOOD CA
90305-0332
US

V. Phone/Fax

Practice location:
  • Phone: 213-375-4421
  • Fax:
Mailing address:
  • Phone: 213-375-4421
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name: TINA BROWN
Title or Position: FOUNDER, CEO & MANAGING DIRECTOR
Credential:
Phone: 213-375-4421