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General NPI Number Information
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NPI Number | 1316486467
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Entity Type | Organization
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Legal Business Name | CHAPLAINCY CARE NETWORK
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Dates
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Enumeration Date | 02/21/2017
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Last Update Date | 02/21/2017
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Provider Practice Location Address
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Address Line | 323 N PRAIRIE AVE SUITE 417
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City | INGLEWOOD
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State | CA
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Zip | 90301-4502
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Country | US
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Telephone | 310-686-8490
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Fax |
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Provider Business Mailing Address
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Address Line | 10747 MAGNOLIA BLVD 418
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91601-4093
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Country | US
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Telephone | 310-936-7703
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Fax |
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Authorized Official
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Title or Position | CO FOUNDER
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Name | DR. LEWIS E LOGAN II
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Credential |
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Telephone | 310-936-7703
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number |
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License Number State | CA
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