MEDICARE: WEST HOLLYWOOD COMMUNITY HOUSING CORPORATION

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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1396630497
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEST HOLLYWOOD COMMUNITY HOUSING CORPORATION

Provider Business Mailing Address
First Line	:	7530 SANTA MONICA BLVD
Second Line	:
City	:	WEST HOLLYWOOD
State	:	CA
Zip	:	90046-6407
Country	:	US
Telephone Number	:	323-650-8771
Fax Number	:	323-650-4745

Provider Business Practice Location Address
First Line	:	7530 SANTA MONICA BLVD
Second Line	:
City	:	WEST HOLLYWOOD
State	:	CA
Zip	:	90046-6407
Country	:	US
Telephone Number	:	323-650-8771
Fax Number	:	323-650-4745

Authorized Official
Title or Position	:	DIRECTOR OF RESIDENT SERVICES
Name	:	DANIEL PEPPER
Credential	:
Telephone Number	:	323-650-8771

Provider Enumeration Date	:	06/10/2025
Last Update Date	:	06/10/2025

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