Provider Demographics
NPI:1740411883
Name:NORMA JORDAN MINISTRIES
Entity Type:Organization
Organization Name:NORMA JORDAN MINISTRIES
Other - Org Name:EMLAC HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CLIFFORD
Authorized Official - Middle Name:
Authorized Official - Last Name:OBI
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:323-590-1272
Mailing Address - Street 1:4275 DEGNAN BLVD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90008-4507
Mailing Address - Country:US
Mailing Address - Phone:323-590-1272
Mailing Address - Fax:
Practice Address - Street 1:4275 DEGNAN BLVD
Practice Address - Street 2:SUITE 3
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90008-4507
Practice Address - Country:US
Practice Address - Phone:323-590-1272
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-06
Last Update Date:2009-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty