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General NPI Number Information
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NPI Number | 1215595392
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Entity Type | Organization
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Legal Business Name | ST. JOSEPH CENTER
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Dates
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Enumeration Date | 06/03/2019
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Last Update Date | 06/03/2019
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Provider Practice Location Address
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Address Line | 8525 S BROADWAY
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City | LOS ANGELES
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State | CA
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Zip | 90003-3334
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Country | US
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Telephone | 323-905-1140
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Fax |
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Provider Business Mailing Address
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Address Line | 8525 S BROADWAY
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City | LOS ANGELES
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State | CA
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Zip | 90003-3334
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Country | US
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Telephone | 323-905-1140
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Fax | 323-905-1163
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Authorized Official
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Title or Position | DIRECTOR OF FINANCE
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Name | MARIA SOCORRO LAPUS
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Credential | DO
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Telephone | 310-396-6468
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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