Healthcare Provider Details

I. General information

NPI: 1285496505
Provider Name (Legal Business Name): WALTER & BONNIE BROWN VETERAN SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2024
Last Update Date: 01/27/2024
Certification Date: 01/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

249 S MANHATTAN PL
LOS ANGELES CA
90004-7005
US

IV. Provider business mailing address

249 S MANHATTAN PL
LOS ANGELES CA
90004-7005
US

V. Phone/Fax

Practice location:
  • Phone: 213-381-2566
  • Fax:
Mailing address:
  • Phone: 213-381-2566
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code177F00000X
TaxonomyLodging Provider
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name: BONNIE BROWN
Title or Position: CEO
Credential:
Phone: 213-381-2566