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General NPI Number Information
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NPI Number | 1720300783
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Entity Type | Organization
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Legal Business Name | KIDZ KINGDOM PDHC
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Dates
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Enumeration Date | 02/18/2010
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Last Update Date | 02/18/2010
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Provider Practice Location Address
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Address Line | 13022 SHERMAN WAY
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91605-4955
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Country | US
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Telephone | 818-554-0927
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Fax | 626-447-9657
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Provider Business Mailing Address
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Address Line | 13022 SHERMAN WAY
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91605-4955
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Country | US
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Telephone | 818-554-0927
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Fax | 626-447-9657
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Authorized Official
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Title or Position | ADMINISTRATOR / OWNER
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Name | MRS. DEBORAH J HATCH
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Credential | REGISTERED NURSE
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Telephone | 818-554-0927
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3140N1450X
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Taxonomy Name | Pediatric Skilled Nursing Facility
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License Number |
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License Number State |
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