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General NPI Number Information
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NPI Number | 1477746824
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Entity Type | Organization
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Legal Business Name | VISTA DEL MAR CHILD AND FAMILY SERVICES
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Dates
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Enumeration Date | 08/20/2007
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Last Update Date | 03/03/2025
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Provider Practice Location Address
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Address Line | 1225 W 190TH ST STE 103
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City | GARDENA
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State | CA
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Zip | 90248-4315
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Country | US
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Telephone | 310-836-1223
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Fax | 310-838-6028
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Provider Business Mailing Address
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Address Line | 1225 W 190TH ST STE 103
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City | GARDENA
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State | CA
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Zip | 90248-4315
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Country | US
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Telephone | 310-836-1223
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Fax | 310-838-6028
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Authorized Official
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Title or Position | DIRECTOR QUALITY, STANDARDS AND COM
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Name | CHERYL CARRINGTON
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Credential |
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Telephone | 310-836-1223
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #2
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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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