Provider Demographics
NPI:1710437082
Name:PEOPLE COORDINATED SERVICES OF SOUTHERN CALIFORNIA, INC.
Entity Type:Organization
Organization Name:PEOPLE COORDINATED SERVICES OF SOUTHERN CALIFORNIA, INC.
Other - Org Name:CASTLE SUBSTANCE ABUSE PROGRAM WEST
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:VIRGIE
Authorized Official - Middle Name:PRICE
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-735-1231
Mailing Address - Street 1:1221 S WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90006-3107
Mailing Address - Country:US
Mailing Address - Phone:323-735-1231
Mailing Address - Fax:323-735-7059
Practice Address - Street 1:1319 S MANHATTAN PL
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90019-4702
Practice Address - Country:US
Practice Address - Phone:323-734-1143
Practice Address - Fax:323-735-7059
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PEOPLE COORDINATED SERVICES OF SOUTHERN CALIFORNIA, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-10-10
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA190013AN324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility