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General NPI Number Information
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NPI Number | 1114124849
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Entity Type | Organization
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Legal Business Name | PROMISING FUTURES INC.
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Dates
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Enumeration Date | 06/27/2007
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Last Update Date | 02/07/2008
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Provider Practice Location Address
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Address Line | 12960 HA HANA RD
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City | LAKESIDE
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State | CA
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Zip | 92040-5004
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Country | US
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Telephone | 619-390-4634
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Fax |
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Provider Business Mailing Address
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Address Line | 12960 HA HANA RD
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City | LAKESIDE
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State | CA
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Zip | 92040-5004
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MARTHA J MORRISSEY
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Credential |
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Telephone | 619-390-4277
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number | LTC60679F
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License Number State | CA
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