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General NPI Number Information
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NPI Number | 1285760074
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Entity Type | Organization
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Legal Business Name | TRANSITIONAL LIVING CENTERS FOR LOS ANGELES COUNTY, INC.
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 16129 PRAIRIE AVE
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City | LAWNDALE
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State | CA
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Zip | 90260-2759
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Country | US
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Telephone | 310-542-4825
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Fax | 310-542-4552
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Provider Business Mailing Address
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Address Line | 16119 PRAIRIE AVE
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City | LAWNDALE
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State | CA
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Zip | 90260-2714
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Country | US
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Telephone | 310-542-4825
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Fax | 310-542-4552
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KENNETH PARKER
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Credential | PH.D.
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Telephone | 310-542-4825
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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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 | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State | CA
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