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General NPI Number Information
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NPI Number | 1972090710
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Entity Type | Organization
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Legal Business Name | COMMUNITY REFLECTIONS INC
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Dates
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Enumeration Date | 04/17/2018
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Last Update Date | 04/17/2018
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Provider Practice Location Address
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Address Line | 10020 SO. WESTERN AVE 10020 SO. WESTERN AVE
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City | LOS ANGELES
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State | CA
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Zip | 90049
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Country | US
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Telephone | 323-756-1347
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Fax | 323-756-1351
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Provider Business Mailing Address
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Address Line | 10020 SO WESTERN AVE.
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City | LOS ANGELES
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State | CA
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Zip | 90047
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Country | US
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Telephone | 323-756-1347
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Fax |
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Authorized Official
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Title or Position | CEO-COUNSLOR
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Name | MR. JULIUS L. VADEN
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Credential |
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Telephone | 323-756-1437
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State | CA
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