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General NPI Number Information
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NPI Number | 1477138899
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Entity Type | Organization
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Legal Business Name | HOME AT LAST COMMUNITY DEVELOPMENT CORPORATION
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Dates
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Enumeration Date | 03/17/2021
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Last Update Date | 03/17/2021
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Provider Practice Location Address
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Address Line | 1426 PALOMA ST
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City | LOS ANGELES
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State | CA
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Zip | 90021-2620
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Country | US
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Telephone | 323-917-8843
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Fax |
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Provider Business Mailing Address
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Address Line | 3425 W MANCHESTER BLVD
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City | INGLEWOOD
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State | CA
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Zip | 90305-2101
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Country | US
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Telephone | 323-917-8843
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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 | MIRNA BELTRAN
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Credential | LCSW
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Telephone | 323-917-8843
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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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Taxonomy #2
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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