Provider Demographics
NPI:1487086989
Name:CENTRAL NEIGHBORHOOD HEALTH FOUNDATION
Entity type:Organization
Organization Name:CENTRAL NEIGHBORHOOD HEALTH FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:NUSRATH
Authorized Official - Middle Name:FATIMA
Authorized Official - Last Name:JAHANGIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-234-5000
Mailing Address - Street 1:2614 S. GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90007
Mailing Address - Country:US
Mailing Address - Phone:323-234-5000
Mailing Address - Fax:323-234-3900
Practice Address - Street 1:2614 S GRAND AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90007-2607
Practice Address - Country:US
Practice Address - Phone:323-234-5000
Practice Address - Fax:323-234-3900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-07
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X, 251B00000X, 251X00000X
CA261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No251X00000XAgenciesSupports Brokerage
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1639336803Medicaid