Provider Demographics
NPI:1891985966
Name:THE CENTER FOR NEW IMAGE INC
Entity Type:Organization
Organization Name:THE CENTER FOR NEW IMAGE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DELE
Authorized Official - Middle Name:
Authorized Official - Last Name:AKANMU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-293-9722
Mailing Address - Street 1:4708 CRENSHAW BLVD
Mailing Address - Street 2:SUITE 101-105
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90043-1215
Mailing Address - Country:US
Mailing Address - Phone:323-293-9722
Mailing Address - Fax:323-293-9722
Practice Address - Street 1:4708 CRENSHAW BLVD
Practice Address - Street 2:SUITE 101-105
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90043-1215
Practice Address - Country:US
Practice Address - Phone:323-293-9722
Practice Address - Fax:323-293-9722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-25
Last Update Date:2009-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management