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Contact Information

LARRY MAXWELL
4445 BURNS AVE
LOS ANGELES, CA90029-2702
 Phone: 323-664-8940
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Substance Abuse Disorder Rehabilitation Facility

324500000X
Indicates primary specialty

NPI Profile & details for

NPI Number 1336687821
Entity Organization
Organization subpart 1 Not specified
Enumeration date 02/06/2017
Last updated 02/06/2017 - About 9 years ago
Identifiers
CA License # R1236821116
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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