Healthcare Provider Details

I. General information

NPI: 1154645208
Provider Name (Legal Business Name): JIKOLE HELPING HANDS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2010
Last Update Date: 03/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 E HILLCREST BLVD
INGLEWOOD CA
90301-2405
US

IV. Provider business mailing address

317 E HILLCREST BLVD
INGLEWOOD CA
90301-2405
US

V. Phone/Fax

Practice location:
  • Phone: 310-292-9941
  • Fax:
Mailing address:
  • Phone: 310-292-9941
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number
License Number StateCA

VIII. Authorized Official

Name: MS. ROSALINE N CHIMA
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 310-292-9941