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General NPI Number Information
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NPI Number | 1265738546
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Entity Type | Organization
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Legal Business Name | OPEN ARMS MENS CENTER
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Dates
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Enumeration Date | 02/02/2011
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Last Update Date | 02/02/2011
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Provider Practice Location Address
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Address Line | 605 N PARK AVE
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City | POMONA
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State | CA
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Zip | 91768-3622
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Country | US
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Telephone | 323-855-5656
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Fax | 424-228-4231
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Provider Business Mailing Address
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Address Line | 8306 WILSHIRE BLVD 7024
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-2382
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Country | US
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Telephone | 323-855-5656
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Fax | 424-228-4231
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Authorized Official
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Title or Position | CEO
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Name | RHONDA ANN LABOMME
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Credential |
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Telephone | 323-855-5656
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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 |
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License Number State |
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