Healthcare Provider Details

I. General information

NPI: 1144154014
Provider Name (Legal Business Name): FIREFLY IN THE SKY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8319 CRENSHAW BLVD
INGLEWOOD CA
90305-1705
US

IV. Provider business mailing address

8319 CRENSHAW BLVD
INGLEWOOD CA
90305-1705
US

V. Phone/Fax

Practice location:
  • Phone: 714-340-9001
  • Fax:
Mailing address:
  • Phone: 714-340-9001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: MELISSA ANN WARES
Title or Position: CEO
Credential: WARES
Phone: 714-340-9001