Healthcare Provider Details

I. General information

NPI: 1629407440
Provider Name (Legal Business Name): THE WHOLE CHILD - MENTAL HEALTH & HOUSING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2013
Last Update Date: 09/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12225 BEVERLY BLVD
WHITTIER CA
90601-2966
US

IV. Provider business mailing address

10155 COLIMA RD
WHITTIER CA
90603-2042
US

V. Phone/Fax

Practice location:
  • Phone: 562-692-0383
  • Fax: 562-692-0380
Mailing address:
  • Phone: 562-692-0383
  • Fax: 562-692-0380

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: STACY ENOMOTO
Title or Position: CFO
Credential:
Phone: 562-692-0383