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General NPI Number Information
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NPI Number | 1548789753
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Entity Type | Organization
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Legal Business Name | 1736 FAMILY CRISIS CENTER
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Dates
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Enumeration Date | 09/19/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2116 ARLINGTON AVE STE 200
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City | LOS ANGELES
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State | CA
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Zip | 90018-1353
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Country | US
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Telephone | 323-737-3900
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Fax |
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Provider Business Mailing Address
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Address Line | 2116 ARLINGTON AVE STE 200
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City | LOS ANGELES
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State | CA
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Zip | 90018-1353
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Country | US
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Telephone | 323-737-3900
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Fax |
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Authorized Official
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Title or Position | EMPLOYMENT SPECIALIST
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Name | DEZARAY ROEBUCK
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Credential |
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Telephone | 323-737-3900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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