Provider Demographics
NPI:1609217173
Name:DEPARTMENT OF MENTAL HEALTH
Entity Type:Organization
Organization Name:DEPARTMENT OF MENTAL HEALTH
Other - Org Name:MEN'S COUNTY JAIL DMH
Other - Org Type:Other Name
Authorized Official - Title/Position:PSYCH SW II
Authorized Official - Prefix:MRS
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:LUJAN
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:213-473-6100
Mailing Address - Street 1:1423 HEPNER AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90041-3107
Mailing Address - Country:US
Mailing Address - Phone:323-809-9553
Mailing Address - Fax:
Practice Address - Street 1:440 BAUCHET STREET
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90012
Practice Address - Country:US
Practice Address - Phone:213-473-6100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-12
Last Update Date:2013-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management