Healthcare Provider Details

I. General information

NPI: 1043783095
Provider Name (Legal Business Name): UNITED COMMUNITY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2019
Last Update Date: 01/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 E HARVARD ST UNIT A
GLENDALE CA
91205-1114
US

IV. Provider business mailing address

501 E HARVARD ST UNIT A
GLENDALE CA
91205-1114
US

V. Phone/Fax

Practice location:
  • Phone: 310-999-3122
  • Fax:
Mailing address:
  • Phone: 310-999-3122
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARIANNA BABAYAN
Title or Position: PRESIDENT
Credential:
Phone: 310-999-3122