1346543964 NPI number — CHILDS HOMES FOR CHILDERN

Table of content: (NPI 1346543964)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346543964 NPI number — CHILDS HOMES FOR CHILDERN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHILDS HOMES FOR CHILDERN
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:
CONNECTING MENTAL HEALTH & OUTREACH SERVICES
Provider Other Organization Name Type Code:
3
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:
1346543964
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/07/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7054 VANSCOY AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTH HOLLYWOOD
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91605-5357
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
818-765-5900
Provider Business Mailing Address Fax Number:
818-759-6072

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7054 VANSCOY AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTH HOLLYWOOD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91605-5357
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-765-5900
Provider Business Practice Location Address Fax Number:
818-759-6072
Provider Enumeration Date:
12/21/2010

Additional Information

Authorized Official

Authorized Official Last Name:
CHILDS
Authorized Official First Name:
RUFUS
Authorized Official Middle Name:
PRINCE
Authorized Official Title or Position:
DIRECTOR/CEO
Authorized Official Telephone Number:
818-765-5900

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 251300000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251B00000X , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 273Y00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 322D00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BN1400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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