Provider Demographics
NPI: | 1326164245 |
---|---|
Name: | MENTAL HEALTH AMERICA OF LOS ANGELES |
Entity Type: | Organization |
Organization Name: | MENTAL HEALTH AMERICA OF LOS ANGELES |
Other - Org Name: | MHALA INTEGRATED SERVICE CENTER LB |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | PRESIDENT & CEO |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | CHRISTINA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | MILLER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | PHD |
Authorized Official - Phone: | 562-285-1330 |
Mailing Address - Street 1: | 200 PINE AVE STE 400 |
Mailing Address - Street 2: | |
Mailing Address - City: | LONG BEACH |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 90802-3039 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 562-285-1330 |
Mailing Address - Fax: | 562-263-3395 |
Practice Address - Street 1: | 1955 LONG BEACH BLVD STE 200 |
Practice Address - Street 2: | |
Practice Address - City: | LONG BEACH |
Practice Address - State: | CA |
Practice Address - Zip Code: | 90806-5501 |
Practice Address - Country: | US |
Practice Address - Phone: | 562-437-6717 |
Practice Address - Fax: | 562-437-5072 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2007-03-22 |
Last Update Date: | 2021-10-29 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 251S00000X | Agencies | Community/Behavioral Health |