Provider Demographics
NPI:1275901209
Name:LAUNCH
Entity Type:Organization
Organization Name:LAUNCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMISSIONS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:310-779-4476
Mailing Address - Street 1:1849 SAWTELLE BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-7007
Mailing Address - Country:US
Mailing Address - Phone:501-993-2595
Mailing Address - Fax:
Practice Address - Street 1:1849 SAWTELLE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-7007
Practice Address - Country:US
Practice Address - Phone:424-832-7627
Practice Address - Fax:424-832-7629
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-08
Last Update Date:2019-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility