MEDICARE: ENRICHMENT INTERVENTION FAMILY CENTER

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	225100000X	Physical Therapist
2	225X00000X	Occupational Therapist
3	235Z00000X	Speech-Language Pathologist
4	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1730642117
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ENRICHMENT INTERVENTION FAMILY CENTER

Provider Business Mailing Address
First Line	:	21051 WARNER CENTER LN STE 100
Second Line	:
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91367-6566
Country	:	US
Telephone Number	:	424-400-4119
Fax Number	:

Provider Business Practice Location Address
First Line	:	21051 WARNER CENTER LN STE 100
Second Line	:
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91367-6566
Country	:	US
Telephone Number	:	424-400-4119
Fax Number	:	888-375-2151

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	INNA PINKHASOVA
Credential	:
Telephone Number	:	424-400-4119

Provider Enumeration Date	:	04/11/2019
Last Update Date	:	11/09/2023

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