Provider Demographics
NPI:1659733327
Name:VOLUNTEERS OF AMERICA OF LOS ANGELES
Entity Type:Organization
Organization Name:VOLUNTEERS OF AMERICA OF LOS ANGELES
Other - Org Name:JAN CLAYTON CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INTERNAL LEGAL COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:CANEEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:FRASER
Authorized Official - Suffix:
Authorized Official - Credentials:ESQ
Authorized Official - Phone:213-251-7698
Mailing Address - Street 1:3600 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 1500
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010-2603
Mailing Address - Country:US
Mailing Address - Phone:213-389-1500
Mailing Address - Fax:213-383-2493
Practice Address - Street 1:4969 W SUNSET BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-5813
Practice Address - Country:US
Practice Address - Phone:213-389-1500
Practice Address - Fax:213-383-2493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-22
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA190027AN324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility