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General NPI Number Information
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NPI Number | 1487535480
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Entity Type | Organization
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Legal Business Name | SHILOH GOG MINISTRIES
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Dates
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Enumeration Date | 09/08/2025
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Last Update Date | 09/08/2025
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Provider Practice Location Address
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Address Line | 6125 WHITTIER BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90022-4503
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Country | US
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Telephone | 323-979-1980
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Fax |
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Provider Business Mailing Address
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Address Line | 6125 WHITTIER BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90022-4503
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Country | US
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Telephone | 323-979-1980
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | EILEEN S KNOX
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Credential | DPA
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Telephone | 310-279-8606
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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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 | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 177F00000X
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Taxonomy Name | Lodging Provider
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License Number |
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License Number State |
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Taxonomy #5
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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 #6
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Taxonomy Code | 405300000X
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Taxonomy Name | Prevention Professional
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License Number |
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License Number State |
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