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General NPI Number Information
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NPI Number | 1023147139
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Entity Type | Organization
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Legal Business Name | D'VEAL FAMILY & YOUTH SERVICES
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 02/03/2020
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Provider Practice Location Address
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Address Line | 2750 E WASHINGTON BLVD SUITE 230, 240, 250, 260
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City | PASADENA
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State | CA
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Zip | 91107-1448
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Country | US
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Telephone | 626-296-8900
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Fax | 626-405-8973
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Provider Business Mailing Address
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Address Line | 2750 E WASHINGTON BLVD SUITE 230 AND 240
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City | PASADENA
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State | CA
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Zip | 91107-1448
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Country | US
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Telephone | 626-296-8900
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Fax | 626-405-8973
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Authorized Official
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Title or Position | CEO/D'VEAL FAMILY & YOUTH SERVICES
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Name | MR. JOHN TERRY MCCALL
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Credential | LCSW
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Telephone | 626-296-8900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | LCSW11363
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License Number State | CA
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