Fred Jefferson Memorial Home for Boys
Fred Jefferson Memorial Home for Boys is a Community/Behavioral Health Agency in Gardena, California. Licensed in California. Registered with an NPI since 2007.
- Licensed in
- CA
- In the registry since
- 2007
Practice location Address checks out
152 W Walnut St Ste 150Gardena, CA 90248-3146
Phone: (310) 763-1660
Fax: (310) 763-1660
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Community/Behavioral Health Agency (primary) | Taxonomy 251S00000X · Licence 197804218 (CA) |
|---|
Record details
| NPI number | 1659561223 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Niquelle Lewis — Executive Director · (310) 763-1660 |
| NPI enumerated | July 30, 2007 |
| Last updated in NPPES | March 3, 2020 |
| Certification date | March 3, 2020 |
| Mailing address | 152 W Walnut St Ste 150, Gardena, CA 90248-3146 |
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