Provider Demographics
NPI:1508206848
Name:PERSONAL INVOLVEMENT CENTER
Entity Type:Organization
Organization Name:PERSONAL INVOLVEMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MAXINE
Authorized Official - Middle Name:
Authorized Official - Last Name:DIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-565-2303
Mailing Address - Street 1:8220 S SAN PEDRO ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90003-3030
Mailing Address - Country:US
Mailing Address - Phone:323-565-2300
Mailing Address - Fax:323-750-0018
Practice Address - Street 1:5311 S WESTERN AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90062-2703
Practice Address - Country:US
Practice Address - Phone:323-565-2300
Practice Address - Fax:323-750-0018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-01
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7542251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health