NPI 1104905140

County of Los Angeles

Organisation Mental Illness Community Based Residential Treatment Facility Los Angeles, CA

Practice location

Address: 3811 Edgehill Dr, Los Angeles, CA 90008-1932
Phone: (323) 291-7275

Authorised official

Name: Vivian B Watts
Title: Mental Health Counselor RN
Phone: (310) 668-6862

Registered specialties

Mental Illness Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320800000X Licence 328506 (CA)

Other Community Based Residential Treatment Facility, Mental Illness providers in California →

Registry record

NPI: 1104905140
Entity type: Organization
NPI issued: 2 Nov 2006
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.