MEDICARE: R.I.G.H.T. PROGRAM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	190513AP	CA

General Provider Information

NPI Number	:	1225329048
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	R.I.G.H.T. PROGRAM

Provider Business Mailing Address
First Line	:	1704 W MANCHESTER AVE
Second Line	:	SUITE # 103
City	:	LOS ANGELES
State	:	CA
Zip	:	90047-3063
Country	:	US
Telephone Number	:	323-751-4778
Fax Number	:	323-751-5502

Provider Business Practice Location Address
First Line	:	4066 W 17TH ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90019-6025
Country	:	US
Telephone Number	:	323-730-4300
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	MS. LISA ANUGWOM
Credential	:
Telephone Number	:	323-751-4778

Provider Enumeration Date	:	04/27/2011
Last Update Date	:	04/27/2011

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