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General NPI Number Information
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NPI Number | 1659597037
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Entity Type | Organization
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Legal Business Name | RUSSIAN JEWISH COMMUNITY CULTURAL CENTER
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 7636 SANTA MONICA BLVD
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City | WEST HOLLYWOOD
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State | CA
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Zip | 90046
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Country | US
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Telephone | 323-650-8118
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Fax | 323-650-8504
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Provider Business Mailing Address
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Address Line | 7636 SANTA MONICA BLVD
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City | WEST HOLLYWOOD
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State | CA
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Zip | 90046
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Country | US
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Telephone | 323-650-8118
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Fax | 323-650-8504
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Authorized Official
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Title or Position | CHAIR OF THE BOARD
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Name | MR. NAFTOLI ESTULIN
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Credential |
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Telephone | 323-650-8118
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385HR2065X
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Taxonomy Name | Child Physical Disabilities Respite Care
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License Number |
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License Number State | CA
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