Provider Demographics
NPI:1255669388
Name:SOUTH BAY HUMAN SERVICES COALITION INC
Entity Type:Organization
Organization Name:SOUTH BAY HUMAN SERVICES COALITION INC
Other - Org Name:SOUTH BAY HUMAN SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DOLORES
Authorized Official - Middle Name:N
Authorized Official - Last Name:LYTTLE
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:310-328-0780
Mailing Address - Street 1:2370 W CARSON ST
Mailing Address - Street 2:SUITE 136
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90501-3100
Mailing Address - Country:US
Mailing Address - Phone:310-328-0780
Mailing Address - Fax:310-328-0175
Practice Address - Street 1:2370 W CARSON ST
Practice Address - Street 2:SUITE 136
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90501-3100
Practice Address - Country:US
Practice Address - Phone:310-328-0780
Practice Address - Fax:310-328-0175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-01
Last Update Date:2010-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA190268AN251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health