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General NPI Number Information
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NPI Number | 1346402831
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Entity Type | Organization
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Legal Business Name | WB COMMUNITY LEARNING CENTER INC
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Dates
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Enumeration Date | 06/26/2008
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Last Update Date | 06/30/2008
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Provider Practice Location Address
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Address Line | 8443 CRENSHAW BLVD SUITE 103
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City | INGLEWOOD
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State | CA
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Zip | 90305-1900
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Country | US
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Telephone | 323-778-7254
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Fax | 323-777-1025
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Provider Business Mailing Address
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Address Line | 8443 CRENSHAW BLVD SUITE 103
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City | INGLEWOOD
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State | CA
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Zip | 90305-1900
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Country | US
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Telephone | 323-778-7254
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Fax | 323-777-1025
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MISS LOIS MARIE LEBLANC
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Credential | BA
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Telephone | 323-778-7254
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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