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General NPI Number Information
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NPI Number | 1275083198
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Entity Type | Organization
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Legal Business Name | FLEMING & BARNES, INC.
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Dates
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Enumeration Date | 10/04/2016
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Last Update Date | 03/12/2019
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Provider Practice Location Address
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Address Line | 2509 W 115TH PL
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City | HAWTHORNE
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State | CA
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Zip | 90250-1968
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Country | US
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Telephone | 310-791-3064
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Fax | 323-777-6259
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Provider Business Mailing Address
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Address Line | PO BOX 4446
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City | PALOS VERDES PENINSULA
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State | CA
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Zip | 90274-9595
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Country | US
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Telephone | 310-791-3064
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Fax | 310-791-3084
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Authorized Official
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Title or Position | DIRECTOR
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Name | KENNETH FLEMING
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Credential |
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Telephone | 310-791-3064
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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 | 198204471
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License Number State | CA
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