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General NPI Number Information
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NPI Number | 1629677141
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Entity Type | Organization
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Legal Business Name | AM EARLY INTERVENTION
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Dates
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Enumeration Date | 10/26/2020
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Last Update Date | 10/26/2020
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Provider Practice Location Address
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Address Line | 653 N CAHUENGA BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90004-1103
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Country | US
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Telephone | 323-469-8994
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Fax |
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Provider Business Mailing Address
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Address Line | 310 S ALMONT DR APT 209
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City | LOS ANGELES
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State | CA
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Zip | 90048-3756
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Country | US
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Telephone | 310-977-1923
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. ALANA R MOLINA
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Credential | BA
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Telephone | 310-977-1923
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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