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NPI Code Detail

MEDICARE: SPECIAL SERVICE FOR GROUPS

MEDICARE: SPECIAL SERVICE FOR GROUPS
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1891826970
Entity Type Code : Organization
Provider Name (Legal Business Name) : SPECIAL SERVICE FOR GROUPS
Provider Business Mailing Address
First Line : 605 W OLYMPIC BLVD
Second Line : SUITE 600
City : LOS ANGELES
State : CA
Zip : 90015-1400
Country : US
Telephone Number : 213-553-1800
Fax Number :
Provider Business Practice Location Address
First Line : 520 S LA FAYETTE PARK PL
Second Line : #300
City : LOS ANGELES
State : CA
Zip : 90057-1607
Country : US
Telephone Number : 213-252-2100
Fax Number :
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : HERBERT K. HATANAKA
Credential :
Telephone Number : 213-553-1800
Provider Enumeration Date : 03/08/2007
Last Update Date : 02/24/2012

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Directions to “SPECIAL SERVICE FOR GROUPS ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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