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General NPI Number Information
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NPI Number | 1811237928
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Entity Type | Organization
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Legal Business Name | THE LGBT COMMUNITY CENTER
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Dates
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Enumeration Date | 02/26/2013
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Last Update Date | 02/26/2013
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Provider Practice Location Address
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Address Line | 3909 CENTRE ST
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City | SAN DIEGO
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State | CA
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Zip | 92103-3410
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Country | US
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Telephone | 619-692-2077
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Fax | 619-718-6447
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Provider Business Mailing Address
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Address Line | 3909 CENTRE ST
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City | SAN DIEGO
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State | CA
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Zip | 92103-3410
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Country | US
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Telephone | 619-692-2077
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Fax | 619-718-6447
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Authorized Official
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Title or Position | DATABASE MANAGER
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Name | AUTUMN RASHAK
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Credential |
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Telephone | 619-692-2077
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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 |
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