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General NPI Number Information
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NPI Number | 1154452159
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Entity Type | Organization
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Legal Business Name | HATHAWAY-SYCAMORES CHILDREN AND FAMILY SERVICES
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2933 EL NIDO DR
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City | ALTADENA
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State | CA
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Zip | 91001-4529
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Country | US
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Telephone | 626-395-7100
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Fax |
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Provider Business Mailing Address
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Address Line | 2933 EL NIDO DR
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City | ALTADENA
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State | CA
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Zip | 91001-4529
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Country | US
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Telephone | 626-395-7100
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Fax |
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Authorized Official
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Title or Position | MENTAL HEALTH DIRECTOR
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Name | MS. DEBORAH MOREHEAD
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Credential | LMFT
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Telephone | 626-395-7100
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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 | 1041C0700X
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License Number State | CA
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