Healthcare Provider Details

I. General information

NPI: 1346543964
Provider Name (Legal Business Name): CHILDS HOMES FOR CHILDERN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2010
Last Update Date: 01/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7054 VANSCOY AVE
NORTH HOLLYWOOD CA
91605-5357
US

IV. Provider business mailing address

7054 VANSCOY AVE
NORTH HOLLYWOOD CA
91605-5357
US

V. Phone/Fax

Practice location:
  • Phone: 818-765-5900
  • Fax: 818-759-6072
Mailing address:
  • Phone: 818-765-5900
  • Fax: 818-759-6072

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MR. RUFUS PRINCE CHILDS
Title or Position: DIRECTOR/CEO
Credential:
Phone: 818-765-5900