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General NPI Number Information
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NPI Number | 1225240393
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Entity Type | Organization
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Legal Business Name | LOS ANGELES NEW LIFE CENTER, INC.
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 02/07/2014
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Provider Practice Location Address
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Address Line | 1818 S WESTERN AVE 300
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City | LOS ANGELES
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State | CA
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Zip | 90006-5807
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Country | US
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Telephone | 323-734-3677
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Fax | 323-734-4972
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Provider Business Mailing Address
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Address Line | 1818 S WESTERN AVE 300
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City | LOS ANGELES
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State | CA
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Zip | 90006-5807
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Country | US
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Telephone | 323-734-3677
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Fax | 323-734-4972
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. JUDE O. OGOKE
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Credential |
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Telephone | 323-734-3677
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 6756
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License Number State | CA
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