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General NPI Number Information
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NPI Number | 1134420953
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Entity Type | Organization
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Legal Business Name | AIDS SERVICE CENTER
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Dates
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Enumeration Date | 11/10/2010
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Last Update Date | 11/10/2010
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Provider Practice Location Address
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Address Line | 909 S FAIR OAKS AVE
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City | PASADENA
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State | CA
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Zip | 91105-2625
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Country | US
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Telephone | 626-441-8495
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Fax | 626-441-5003
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Provider Business Mailing Address
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Address Line | 909 S FAIR OAKS AVE
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City | PASADENA
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State | CA
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Zip | 91105-2625
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Country | US
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Telephone | 626-441-8495
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Fax | 626-441-5003
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Authorized Official
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Title or Position | DIRECTOR OR PROGRAM OPERATIONS
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Name | KAREN TINSLEY
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Credential | LCSW
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Telephone | 626-441-8495
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | LCS19757
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License Number State | CA
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