Healthcare Provider Details
I. General information
NPI: 1023905379
Provider Name (Legal Business Name): FATHERS AND MOTHERS WHO CARE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/19/2025
Last Update Date: 07/29/2025
Certification Date: 07/29/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10975 S VERMONT AVE
LOS ANGELES CA
90044-3041
US
IV. Provider business mailing address
10975 S VERMONT AVE
LOS ANGELES CA
90044-3041
US
V. Phone/Fax
- Phone: 323-247-7667
- Fax: 323-328-1698
- Phone: 323-247-7667
- Fax: 323-328-1698
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 174200000X |
| Taxonomy | Meals Provider |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 177F00000X |
| Taxonomy | Lodging Provider |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251B00000X |
| Taxonomy | Case Management Agency |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251C00000X |
| Taxonomy | Developmentally Disabled Services Day Training Agency |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251X00000X |
| Taxonomy | Supports Brokerage Agency |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 385H00000X |
| Taxonomy | Respite Care |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LINDA
KELLY
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 323-247-7667