Healthcare Provider Details

I. General information

NPI: 1063690204
Provider Name (Legal Business Name): HELPING KIDS TO RECOVER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2008
Last Update Date: 02/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14500 LARCH AVENUE LA VIDA WEST CAL - SAFE
LAWNDALE CA
90260-1621
US

IV. Provider business mailing address

637 E ALBERTONI ST SUITE 200
CARSON CA
90746-1539
US

V. Phone/Fax

Practice location:
  • Phone: 310-217-0616
  • Fax: 310-217-0545
Mailing address:
  • Phone: 310-217-0616
  • Fax: 310-217-0545

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3245S0500X
TaxonomyChildren's Substance Abuse Rehabilitation Facility
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MRS. CHYNETHIA BOYD
Title or Position: EXCUTIVE DIRECTOR
Credential: M.B.A.,RAS
Phone: 310-217-0616