MEDICARE: LOS ANGELES COUNTY OF LOS ANGELES-DEPARTMENT OF MENTAL HEALTH

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

General Provider Information

NPI Number	:	1467639112
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOS ANGELES COUNTY OF LOS ANGELES-DEPARTMENT OF MENTAL HEALTH

Provider Business Mailing Address
First Line	:	8300 S VERMONT AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90044-3422
Country	:	US
Telephone Number	:	323-525-6400
Fax Number	:	323-565-2133

Provider Business Practice Location Address
First Line	:	8300 S VERMONT AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90044-3422
Country	:	US
Telephone Number	:	323-525-6400
Fax Number	:	323-565-2133

Authorized Official
Title or Position	:	OUTREACH COORDINATOR
Name	:	MRS. VANESSA CORONA
Credential	:
Telephone Number	:	323-525-6400

Provider Enumeration Date	:	01/24/2008
Last Update Date	:	01/24/2008

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