Provider Demographics
NPI:1952490120
Name:LA COUNTY-DEPT OF MENTAL HEALTH
Entity Type:Organization
Organization Name:LA COUNTY-DEPT OF MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR. MHC-RN
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:GORGONIA
Authorized Official - Last Name:PERCY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:661-723-4260
Mailing Address - Street 1:349 E AVENUE K6
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93535-4508
Mailing Address - Country:US
Mailing Address - Phone:661-723-4260
Mailing Address - Fax:661-945-2495
Practice Address - Street 1:349 E AVENUE K6
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93535-4508
Practice Address - Country:US
Practice Address - Phone:661-723-4260
Practice Address - Fax:661-945-2495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2007-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN375235101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty