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General NPI Number Information
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NPI Number | 1245637362
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Entity Type | Organization
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Legal Business Name | GOD'S PROPERTY SOBER LIVING FOUNDATION
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Dates
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Enumeration Date | 12/04/2014
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Last Update Date | 12/05/2014
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Provider Practice Location Address
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Address Line | 1704 W MANCHESTER AVE SUITE 210
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City | LOS ANGELES
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State | CA
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Zip | 90047-3063
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Country | US
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Telephone | 323-305-1538
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Fax | 323-305-1776
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Provider Business Mailing Address
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Address Line | 1704 W MANCHESTER AVE SUITE 210
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City | LOS ANGELES
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State | CA
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Zip | 90047-3063
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Country | US
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Telephone | 323-305-1538
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Fax | 323-305-1776
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. STEVEN DERRICK FLEMING
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Credential |
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Telephone | 323-420-7345
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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