Provider Demographics
NPI:1760568489
Name:COMPTON METAL HEALTH CENTER
Entity Type:Organization
Organization Name:COMPTON METAL HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:J
Authorized Official - Last Name:ROBLES MONCADA
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:310-668-6800
Mailing Address - Street 1:1833 N KINGSLEY DR APT 10
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-3790
Mailing Address - Country:US
Mailing Address - Phone:213-479-6118
Mailing Address - Fax:
Practice Address - Street 1:921 E COMPTON BLVD FL 1
Practice Address - Street 2:
Practice Address - City:COMPTON
Practice Address - State:CA
Practice Address - Zip Code:90221-3303
Practice Address - Country:US
Practice Address - Phone:310-668-6800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW 18369261QM0801X, 273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Not Answered273R00000XHospital UnitsPsychiatric Unit