INTERCONNECTION CENTER INC. NPI 1902024276

NPI Information

NPI: 1902024276
Provider Name: INTERCONNECTION CENTER INC.

Other Name: GRAND AVENUE CENTER FOR DIGNITY

Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization
Address:
3833 S GRAND AVE
LOS ANGELES, CA
ZIP 90037
Phone: (213) 747-4626
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INTERCONNECTION CENTER INC. is a substance abuse rehabilitation facility in Los Angeles, CA. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. INTERCONNECTION CENTER INC. NPI is 1902024276. The provider is registered as an organization entity type.
The provider Other Name Is Grand Avenue Center For Dignity.

The provider's business location address is:

3833 S GRAND AVE
LOS ANGELES, CA
ZIP 90037-311
Phone: (213) 747-4626

The provider's authorized official is Rudy Butler .
The authorized official title is Excutive Director and has the following contact phone number (213) 747-4626.

The enumeration date for this NPI number is 4/23/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	324500000X	Substance Abuse Rehabilitation Facility		190383AN	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	6893	OTHER	CALIFORNIA	SUBSTANCE ABUSE REHAB

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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