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General NPI Number Information
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NPI Number | 1467963256
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Entity Type | Organization
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Legal Business Name | SPECIAL SERVICE FOR GROUPS, INC.
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Dates
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Enumeration Date | 10/19/2017
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Last Update Date | 11/12/2021
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Provider Practice Location Address
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Address Line | 8627 JUNIPER STREET
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City | LOS ANGELES
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State | CA
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Zip | 90002-1539
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Country | US
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Telephone | 213-553-1800
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Fax |
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Provider Business Mailing Address
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Address Line | 905 E 8TH ST
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City | LOS ANGELES
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State | CA
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Zip | 90021-1848
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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 | EXECUTIVE DIRECTOR
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Name | HERBERT K HATANAKA
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Credential |
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Telephone | 213-553-1800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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