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General NPI Number Information
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NPI Number | 1619105947
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Entity Type | Organization
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Legal Business Name | WEST COAST OUTPATIENT SERVICES, INC
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Dates
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Enumeration Date | 06/25/2009
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Last Update Date | 02/12/2014
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Provider Practice Location Address
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Address Line | 13252 HAWTHORNE BLVD 103
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City | HAWTHORNE
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State | CA
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Zip | 90250-5816
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Country | US
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Telephone | 310-350-9852
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Fax | 310-675-7701
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Provider Business Mailing Address
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Address Line | 727 LOYOLA AVE
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City | CARSON
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State | CA
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Zip | 90746-3903
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Country | US
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Telephone | 310-350-9852
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Fax | 310-675-7701
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JONES A OKEKE SR.
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Credential | M.D.
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Telephone | 310-350-9852
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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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