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General NPI Number Information
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NPI Number | 1134769193
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Entity Type | Organization
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Legal Business Name | 4 KIDS 2 KIDS
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Dates
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Enumeration Date | 01/07/2020
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Last Update Date | 01/07/2020
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Provider Practice Location Address
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Address Line | 1483 ALVA ST
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City | CARPINTERIA
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State | CA
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Zip | 93013-1501
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Country | US
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Telephone | 805-340-3517
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Fax |
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Provider Business Mailing Address
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Address Line | 108 UNIVERSITY AVE
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City | VENTURA
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State | CA
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Zip | 93003-3844
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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 | RESIDENTIAL COUNSELOR
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Name | MRS. KRISTA KESSLER
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Credential |
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Telephone | 805-340-3517
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number |
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License Number State |
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