Provider Demographics
NPI:1639291651
Name:REMAH HEALTH SERVICES
Entity Type:Organization
Organization Name:REMAH HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR,
Authorized Official - Prefix:PROF
Authorized Official - First Name:DORIS.
Authorized Official - Middle Name:NWASOR
Authorized Official - Last Name:ADOH.
Authorized Official - Suffix:I
Authorized Official - Credentials:BS,LVN,MFT INTERN,
Authorized Official - Phone:310-254-8446
Mailing Address - Street 1:15544 RYON AVE
Mailing Address - Street 2:
Mailing Address - City:BELLFLOWER
Mailing Address - State:CA
Mailing Address - Zip Code:90706-3625
Mailing Address - Country:US
Mailing Address - Phone:562-867-5150
Mailing Address - Fax:310-670-0990
Practice Address - Street 1:8929 S SEPULVEDA BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90045-3616
Practice Address - Country:US
Practice Address - Phone:310-670-0911
Practice Address - Fax:310-670-0990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAR1AO509271126101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA197227000OtherPROVIDER NUMBER
CA02206508OtherUNIQUE PROVIDER IDENTIFICATION NUMBER (PIN)
CA02206508Medicaid