| Organization Name: | ST. JOHNS WELL CHILD AND FAMILY CENTER, INC. |
| NPI Number: | 1003068206 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JAMES MANGIA (PRESIDENT, CEO) |
| Mailing Address: | 6505 8th Ave Los Angeles |
| State: | CA US |
| Postal Code: | 900434313 |
| Phone Number: | 3235411600 |
| Fax Number: | 3235411665 |
| NPI Enumeration Date: | 10/21/2008 |
| NPI Last Update Date: | 12/06/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QC1500X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Community Health |
| Taxonomy Definition: | |