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General NPI Number Information
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NPI Number | 1740612167
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Entity Type | Organization
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Legal Business Name | WB COMMUNITY LEARNING CENTER, INC.
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Dates
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Enumeration Date | 08/08/2013
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Last Update Date | 08/08/2013
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Provider Practice Location Address
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Address Line | 3425 W MANCHESTER BLVD #106
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City | INGLEWOOD
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State | CA
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Zip | 90305-2101
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Country | US
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Telephone | 323-778-7254
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5604
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City | INGLEWOOD
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State | CA
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Zip | 90310-5604
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Country | US
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Telephone | 323-778-7254
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Fax |
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Authorized Official
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Title or Position | CEO/ EXECUTIVE DIRECTOR
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Name | MISS LOIS MARIE LEBLANC
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Credential | DR.
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Telephone | 323-777-7316
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | CA
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