Provider Demographics
NPI:1053057216
Name:CALIFORNIA INSTITUTE OF HEALTH & SOCIAL SERVICES, INC.
Entity Type:Organization
Organization Name:CALIFORNIA INSTITUTE OF HEALTH & SOCIAL SERVICES, INC.
Other - Org Name:ALAFIA MENTAL HEALTH INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF PROGRAM ADMINISTRATION
Authorized Official - Prefix:MS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-645-5227
Mailing Address - Street 1:8929 S SEPULVEDA BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-3643
Mailing Address - Country:US
Mailing Address - Phone:310-645-5227
Mailing Address - Fax:310-645-9840
Practice Address - Street 1:555 W REDONDO BEACH BLVD # 215
Practice Address - Street 2:
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90248-1612
Practice Address - Country:US
Practice Address - Phone:310-352-6422
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-10
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health