Provider Demographics
NPI:1659644318
Name:REMAH HEALTH SERVICES
Entity Type:Organization
Organization Name:REMAH HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXEC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DORIS
Authorized Official - Middle Name:NWASOR
Authorized Official - Last Name:ADOH
Authorized Official - Suffix:
Authorized Official - Credentials:COUNSELOR
Authorized Official - Phone:310-254-8446
Mailing Address - Street 1:1524 E 103RD ST
Mailing Address - Street 2:ROOM 6B
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90002-3307
Mailing Address - Country:US
Mailing Address - Phone:323-568-5540
Mailing Address - Fax:323-566-6379
Practice Address - Street 1:1524 E 103RD ST
Practice Address - Street 2:ROOM 6B
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90002-3307
Practice Address - Country:US
Practice Address - Phone:323-568-5540
Practice Address - Fax:323-566-6379
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REMAH HEALTHSERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-02-10
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA190515AN261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder