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General NPI Number Information
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NPI Number | 1265732275
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Entity Type | Organization
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Legal Business Name | CHILD ENRICHMENT CENTER
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Dates
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Enumeration Date | 10/25/2010
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Last Update Date | 10/25/2010
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Provider Practice Location Address
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Address Line | 12007 ALTA CARMEL COURT 318
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City | SAN DIEGO
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State | CA
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Zip | 92128
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Country | US
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Telephone | 858-521-8173
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Fax |
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Provider Business Mailing Address
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Address Line | 30233 SIERRA MADRE DRIVE
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City | TEMECULA
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State | CA
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Zip | 92591
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Country | US
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Telephone | 619-890-2928
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MISS SARAH HAWS
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Credential | MSCP, BCBA
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Telephone | 858-521-8173
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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 |
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License Number State |
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