Healthcare Provider Details

I. General information

NPI: 1699973198
Provider Name (Legal Business Name): WAYFINDER FAMILY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2007
Last Update Date: 06/11/2020
Certification Date: 06/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5300 ANGELES VISTA BLVD
LOS ANGELES CA
90043-1648
US

IV. Provider business mailing address

5300 ANGELES VISTA BLVD
LOS ANGELES CA
90043-1648
US

V. Phone/Fax

Practice location:
  • Phone: 323-295-4555
  • Fax: 323-508-0150
Mailing address:
  • Phone: 323-295-4555
  • Fax: 323-508-0150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. MIKI JORDAN
Title or Position: PRESIDENT /CEO
Credential: MS
Phone: 323-295-4555