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General NPI Number Information
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NPI Number | 1407115918
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Entity Type | Organization
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Legal Business Name | ST. JOSEPH CENTER
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Dates
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Enumeration Date | 05/04/2012
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Last Update Date | 02/27/2023
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Provider Practice Location Address
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Address Line | 8533 WASHINGTON BLVD STE A
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City | CULVER CITY
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State | CA
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Zip | 90232-7462
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Country | US
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Telephone | 310-396-6468
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Fax | 310-392-8402
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Provider Business Mailing Address
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Address Line | 204 HAMPTON DR
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City | VENICE
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State | CA
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Zip | 90291-2623
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Country | US
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Telephone | 310-396-6468
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Fax | 310-392-8402
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Authorized Official
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Title or Position | DIRECTOR OF QA/CLINICAL SERVICES
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Name | MANDY SOMMERS
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Credential |
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Telephone | 310-396-6468
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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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