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General NPI Number Information
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NPI Number | 1437707833
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Entity Type | Organization
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Legal Business Name | D'VEAL FAMILY AND YOUTH SERVICES
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Dates
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Enumeration Date | 08/28/2019
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Last Update Date | 02/12/2025
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Provider Practice Location Address
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Address Line | 90 N DAISY AVE
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City | PASADENA
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State | CA
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Zip | 91107-3704
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Country | US
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Telephone | 626-296-8900
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Fax |
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Provider Business Mailing Address
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Address Line | 2750 E WASHINGTON BLVD STE 230
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City | PASADENA
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State | CA
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Zip | 91107-1449
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Country | US
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Telephone | 626-296-8900
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Fax | 626-296-8911
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Authorized Official
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Title or Position | IBHIS DIRECTOR
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Name | MRS. KIM BLACKMON
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Credential |
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Telephone | 626-296-8900
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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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