Provider Demographics
NPI:1619105947
Name:WEST COAST OUTPATIENT SERVICES, INC
Entity Type:Organization
Organization Name:WEST COAST OUTPATIENT SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JONES
Authorized Official - Middle Name:A
Authorized Official - Last Name:OKEKE
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:310-350-9852
Mailing Address - Street 1:727 LOYOLA AVE
Mailing Address - Street 2:
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90746-3903
Mailing Address - Country:US
Mailing Address - Phone:310-350-9852
Mailing Address - Fax:310-675-7701
Practice Address - Street 1:13252 HAWTHORNE BLVD
Practice Address - Street 2:103
Practice Address - City:HAWTHORNE
Practice Address - State:CA
Practice Address - Zip Code:90250-5816
Practice Address - Country:US
Practice Address - Phone:310-350-9852
Practice Address - Fax:310-675-7701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-25
Last Update Date:2014-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty