Provider Demographics
NPI:1972830792
Name:ALL SAINTS OUTPATIENT CENTER
Entity Type:Organization
Organization Name:ALL SAINTS OUTPATIENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ADEGBENGA
Authorized Official - Middle Name:A
Authorized Official - Last Name:ADETOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-631-2822
Mailing Address - Street 1:3591 EAST IMPERIAL HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:LYNWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90262-2684
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3591 EAST IMPERIAL HIGHWAY
Practice Address - Street 2:
Practice Address - City:LYNWOOD
Practice Address - State:CA
Practice Address - Zip Code:90262-2684
Practice Address - Country:US
Practice Address - Phone:310-631-2838
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-16
Last Update Date:2009-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child