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General NPI Number Information
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NPI Number | 1710437082
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Entity Type | Organization
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Legal Business Name | PEOPLE COORDINATED SERVICES OF SOUTHERN CALIFORNIA, INC.
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Dates
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Enumeration Date | 10/10/2016
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Last Update Date | 10/10/2016
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Provider Practice Location Address
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Address Line | 1319 S MANHATTAN PL
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City | LOS ANGELES
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State | CA
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Zip | 90019-4702
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Country | US
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Telephone | 323-734-1143
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Fax | 323-735-7059
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Provider Business Mailing Address
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Address Line | 1221 S WESTERN AVE
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City | LOS ANGELES
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State | CA
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Zip | 90006-3107
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Country | US
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Telephone | 323-735-1231
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Fax | 323-735-7059
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MS. VIRGIE PRICE WALKER
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Credential |
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Telephone | 323-735-1231
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | 190013AN
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License Number State | CA
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