T H E CLINIC INC


Address: 3834 S. Western Avenue, Los Angeles, CA 90062
Phone: 3237301920

T H E CLINIC INC (NPI# 1023287679) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1023287679
Entity Type Organization
Organization Name T H E CLINIC INC
Other Organization Name T.H.E. CLINIC, INC.
Practice Address 3834 S. Western Avenue
Los Angeles
CA 90062
Practice Telephone 3237301920
Practice Fax Number 3237309777
Mailing Telephone 3237301920
Mailing Fax Number 3237309777
Enumeration Date 2008-02-28
Last Update Date 2013-05-17
Authorized Official Name MS. RISE K. PHILLIPS (PRESIDENT/CEO)
Authorized Official Telephone 3237301920
Authorized Official Credential M.P.H., M.B.A.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261Q00000X Clinic/Center 960001020 CA Ambulatory Health Care Facilities

Other Provider/Organization Names

Other Name Type Code
T.H.E. Clinic, Inc. Doing Business As Name - Organization

Office Location

Street Address 3834 S. WESTERN AVENUE
City LOS ANGELES
State CA
Zip Code 90062

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1033535794 Trusana Monique Hall Licensed Vocational Nurse 4103 S. Halldale Ave, Los Angeles, CA 90062 2014-03-05
1093139644 Daniel Garcia Rehabilitation Practitioner 3381 Western Ave., Los Angeles, CA 90062 2014-02-18
1689003790 Crystal Vernon Case Manager/Care Coordinator 3881 S. Western Avenue, Los Angeles, CA 90062 2013-11-08
1184902934 Gerry Lynn Lockhart Case Manager/Care Coordinator 3881 S Western Avenue, Los Angeles, CA 90062 2011-07-28
1285921692 Atlantic Recovery Services Community/Behavioral Health 1701 Browning Street, Los Angeles, CA 90062 2011-07-06
1174796452 Tacora Leggett Counselor 5311 S Western Avenue, Los Angeles, CA 90062 2008-04-08
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Taxonomy Information

Taxonomy Code 261Q00000X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center

Taxonomy Definition

A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

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1548740939 Mission City Community Network Inc Clinic/Center 5300 Santa Monica Blvd Ste 202, Los Angeles, CA 90029 2018-08-15
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Competitor

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City LOS ANGELES
Zip Code 90062

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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