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General NPI Number Information
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NPI Number | 1417179128
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Entity Type | Organization
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Legal Business Name | NATIONAL COUNCIL OF JEWISH WOMEN-LOS ANGELES
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 07/27/2007
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Provider Practice Location Address
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Address Line | 543 N FAIRFAX AVE
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City | LOS ANGELES
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State | CA
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Zip | 90036-1715
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Country | US
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Telephone | 323-651-2930
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Fax |
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Provider Business Mailing Address
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Address Line | 543 N FAIRFAX AVE
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City | LOS ANGELES
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State | CA
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Zip | 90036-1715
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Country | US
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Telephone | 323-651-2930
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | MS. AVA ROSE
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Credential | LCSW
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Telephone | 323-852-8521
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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 | LCS21692
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License Number State | CA
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