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General NPI Number Information
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NPI Number | 1447458120
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Entity Type | Organization
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Legal Business Name | JUDE OKORO
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Dates
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Enumeration Date | 07/05/2007
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Last Update Date | 02/29/2008
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Provider Practice Location Address
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Address Line | 3875 S WESTERN AVE
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City | LOS ANGELES
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State | CA
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Zip | 90062-1105
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Country | US
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Telephone | 323-290-4379
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Fax |
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Provider Business Mailing Address
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Address Line | 4538 W 159TH ST
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City | LAWNDALE
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State | CA
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Zip | 90260-2513
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Country | US
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Telephone | 323-620-3065
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Fax |
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Authorized Official
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Title or Position | SERVICE COORDINATOR
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Name | MR. JUDE OKORO
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Credential | A.A
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Telephone | 323-290-4364
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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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