1639635154 NPI number — LOVE FOCUS INTERNATIONAL ASSOCIATION LFIA

Table of content: (NPI 1639635154)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639635154 NPI number — LOVE FOCUS INTERNATIONAL ASSOCIATION LFIA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LOVE FOCUS INTERNATIONAL ASSOCIATION LFIA
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:
LOVE FOCUS YOUTH OUTREACH
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:
1639635154
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/02/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 3704
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MERCED
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95344-3704
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
209-869-5800
Provider Business Mailing Address Fax Number:
866-310-8868

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
108 W ALEXANDER AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MERCED
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95348-3410
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
209-233-9024
Provider Business Practice Location Address Fax Number:
866-310-8868
Provider Enumeration Date:
02/20/2019

Additional Information

Authorized Official

Authorized Official Last Name:
NKWOPARA
Authorized Official First Name:
THEOPHILUS
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO/INFORMATION TECHNOLOGY DIRECTOR
Authorized Official Telephone Number:
209-869-5800

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YP2500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 163WC0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 164X00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 171M00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 251B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251C00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251X00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3104A0630X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 320900000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 374K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 285790 . This is a "BVN AND PSYCHIATRIC TECHNICIANS" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 247207212 . This is a "FACILITY" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 768074 . This is a "CALIFORNIA BOARD OF REGISTEREDNURSING - BRN" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 65927 . This is a "BBS/LICENSED CLINICAL SOCIAL WORKER" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 851729 . This is a "CALIFORNIA BOARD OF REGISTEREDNURSING - BRN" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 289669 . This is a "BVN AND PSYCHIATRIC TECHNICIANS" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: C3791162 . This is a "SECRETARY OF STATE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: C4564277 . This is a "SECRETARY OF STATE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 813953 . This is a "CALIFORNIA BOARD OF REGISTEREDNURSING - BRN" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 279040 . This is a "B VN AND PSYCHIATRIC TECHNICIANS" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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