1447381991 NPI number — ENKI HEALTH & RESEARCH SYSTEMS, INC.

Table of content: (NPI 1447381991)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447381991 NPI number — ENKI HEALTH & RESEARCH SYSTEMS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ENKI HEALTH & RESEARCH SYSTEMS, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ENKI YOUTH & FAMILY SERVICES-COVINA
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447381991
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/07/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
150 E OLIVE AVE
Provider Second Line Business Mailing Address:
#203
Provider Business Mailing Address City Name:
BURBANK
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91502-1846
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
818-973-4899
Provider Business Mailing Address Fax Number:
818-973-4888

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
535 S 2ND AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COVINA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91723-3013
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
626-974-0770
Provider Business Practice Location Address Fax Number:
626-974-0774
Provider Enumeration Date:
03/08/2007

Additional Information

Authorized Official

Authorized Official Last Name:
URMER
Authorized Official First Name:
CARL
Authorized Official Middle Name:
W.
Authorized Official Title or Position:
EXECUTIVE VICE PRESIDENT-COO
Authorized Official Telephone Number:
818-973-4899

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000007258 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




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