MEDICARE: HELPING KIDS TO RECOVER, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	252Y00000X	Early Intervention Provider Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700116209
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HELPING KIDS TO RECOVER, INC.

Provider Business Mailing Address
First Line	:	637 E. ALBERTONI ST.
Second Line	:	STE. 200
City	:	CARSON
State	:	CA
Zip	:	90746
Country	:	US
Telephone Number	:	310-217-0616
Fax Number	:	310-217-0545

Provider Business Practice Location Address
First Line	:	2606 N CENTRAL AVE
Second Line	:
City	:	COMPTON
State	:	CA
Zip	:	90222-1640
Country	:	US
Telephone Number	:	310-217-0616
Fax Number	:	310-217-0545

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MRS. CHYNETHIA BOYD
Credential	:	M.B.A.,RAS
Telephone Number	:	310-217-0616

Provider Enumeration Date	:	01/05/2010
Last Update Date	:	01/05/2010

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