Provider Demographics
NPI:1528196029
Name:TRANSITIONAL LIVING CENTERS FOR LOS ANGELES COUNTY, INC.
Entity Type:Organization
Organization Name:TRANSITIONAL LIVING CENTERS FOR LOS ANGELES COUNTY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:310-542-4825
Mailing Address - Street 1:16119 PRAIRIE AVE
Mailing Address - Street 2:
Mailing Address - City:LAWNDALE
Mailing Address - State:CA
Mailing Address - Zip Code:90260-2714
Mailing Address - Country:US
Mailing Address - Phone:310-542-4825
Mailing Address - Fax:310-542-4552
Practice Address - Street 1:4211 W 147TH ST
Practice Address - Street 2:
Practice Address - City:LAWNDALE
Practice Address - State:CA
Practice Address - Zip Code:90260-1654
Practice Address - Country:US
Practice Address - Phone:310-542-4825
Practice Address - Fax:310-542-4552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health