Provider Demographics
NPI:1225240393
Name:LOS ANGELES NEW LIFE CENTER, INC.
Entity Type:Organization
Organization Name:LOS ANGELES NEW LIFE CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JUDE
Authorized Official - Middle Name:O
Authorized Official - Last Name:OGOKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-734-3677
Mailing Address - Street 1:1818 S WESTERN AVE
Mailing Address - Street 2:300
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90006-5807
Mailing Address - Country:US
Mailing Address - Phone:323-734-3677
Mailing Address - Fax:323-734-4972
Practice Address - Street 1:1818 S WESTERN AVE
Practice Address - Street 2:300
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90006-5807
Practice Address - Country:US
Practice Address - Phone:323-734-3677
Practice Address - Fax:323-734-4972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6756101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty