Provider Demographics
NPI:1508946492
Name:TWIN TOWERS CORRECTIONAL FACILITY
Entity Type:Organization
Organization Name:TWIN TOWERS CORRECTIONAL FACILITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MHSC 1
Authorized Official - Prefix:MR
Authorized Official - First Name:SONNY
Authorized Official - Middle Name:
Authorized Official - Last Name:DURON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-473-6574
Mailing Address - Street 1:450 BAUCHET ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90012-2907
Mailing Address - Country:US
Mailing Address - Phone:213-473-6574
Mailing Address - Fax:
Practice Address - Street 1:450 BAUCHET ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90012-2907
Practice Address - Country:US
Practice Address - Phone:213-473-6574
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management