Healthcare Provider Details

I. General information

NPI: 1548101769
Provider Name (Legal Business Name): BLACK KIDS TRAVEL ORGANIZATION INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2026
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

217 E 8TH ST APT 803
LOS ANGELES CA
90014-2394
US

IV. Provider business mailing address

217 E 8TH ST APT 803
LOS ANGELES CA
90014-2394
US

V. Phone/Fax

Practice location:
  • Phone: 614-432-5231
  • Fax:
Mailing address:
  • Phone: 614-432-5231
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. OWEN DANIELS III
Title or Position: FOUNDER
Credential:
Phone: 614-432-5231