Healthcare Provider Details
I. General information
NPI: 1386883379
Provider Name (Legal Business Name): BIENVENIDOS CHILDREN'S CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/13/2009
Last Update Date: 02/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
507 S ATLANTIC BLVD
LOS ANGELES CA
90022-2621
US
IV. Provider business mailing address
316 W 2ND ST STE 800
LOS ANGELES CA
90012-3533
US
V. Phone/Fax
- Phone: 323-268-9191
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251B00000X |
| Taxonomy | Case Management Agency |
| License Number | 190285AN |
| License Number State | CA |
VIII. Authorized Official
Name: MR.
RITCHIE
GEISEL
Title or Position: CEO
Credential:
Phone: 213-785-5906