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General NPI Number Information
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NPI Number | 1093934101
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Entity Type | Organization
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Legal Business Name | SHUTES & LEE, INC
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Dates
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Enumeration Date | 04/25/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1443 S GENESEE AVE
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City | LOS ANGELES
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State | CA
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Zip | 90019-3702
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Country | US
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Telephone | 323-935-2244
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Fax | 323-939-1069
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Provider Business Mailing Address
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Address Line | 1443 S GENESEE AVE
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City | LOS ANGELES
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State | CA
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Zip | 90019-3702
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Country | US
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Telephone | 323-935-2244
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Fax | 323-939-1069
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. BELINDA LEE
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Credential |
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Telephone | 323-935-2244
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State | CA
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