Provider Demographics
NPI:1225498546
Name:CITY OF ANGELS COMMUNITY MENTAL HEALTH CENTER
Entity Type:Organization
Organization Name:CITY OF ANGELS COMMUNITY MENTAL HEALTH CENTER
Other - Org Name:ADULT DAY HEALTH CENTERS OF AMERICA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:A
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:1626-485-7005
Mailing Address - Street 1:2417 BEVERLY BLVD
Mailing Address - Street 2:SUITE 2000
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90057-1001
Mailing Address - Country:US
Mailing Address - Phone:626-792-8400
Mailing Address - Fax:
Practice Address - Street 1:2417 BEVERLY BLVD
Practice Address - Street 2:SUITE 2000
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-1001
Practice Address - Country:US
Practice Address - Phone:626-792-8400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-29
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA054673Medicare Oscar/Certification