Doctor Name: | DEREK BROWN |
NPI Number: | 1477938561 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 13921 Yukon Ave Hawthorne, CA - 90250 |
Business Phone Number: | 5629652087 |
Business Fax Number: | |
Mailing Address: | 13921 Yukon Ave, HAWTHORNE |
State: | CA |
Postal Code: | 902508124 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 07/30/2015 |
NPI Last Update Date: | 08/12/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320800000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Community Based Residential Treatment Facility, Mental Illness |
Taxonomy Specialization: | |
Taxonomy Definition: | A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |