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General NPI Number Information
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NPI Number | 1720544471
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Entity Type | Organization
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Legal Business Name | LOS ANGELES COMMUNITY MENTAL HEALTH CORP
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Dates
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Enumeration Date | 02/19/2019
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Last Update Date | 03/18/2019
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Provider Practice Location Address
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Address Line | 5240 GOLDEN GATE PKWY
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City | NAPLES
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State | FL
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Zip | 34116-7670
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Country | US
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Telephone | 239-692-9510
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Fax | 239-330-7252
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Provider Business Mailing Address
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Address Line | 5240 GOLDEN GATE PKWY
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City | NAPLES
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State | FL
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Zip | 34116-7670
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Country | US
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Telephone | 239-692-9510
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Fax | 239-330-7252
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | ISRAEL IGLESIAS
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Credential |
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Telephone | 786-357-9076
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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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 | 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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