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General NPI Number Information
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NPI Number | 1912575440
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Entity Type | Organization
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Legal Business Name | THE HOUSE OF BETHESDA
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Dates
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Enumeration Date | 06/11/2021
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Last Update Date | 07/23/2021
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Provider Practice Location Address
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Address Line | 14614 FIRMONA AVE
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City | LAWNDALE
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State | CA
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Zip | 90260-1339
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Country | US
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Telephone | 310-675-1444
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Fax | 310-675-1333
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Provider Business Mailing Address
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Address Line | 14614 FIRMONA A VENUE PO BOX 5373 INGLEWOOD, CA 90305
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City | LAWNDALE
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State | CA
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Zip | 90260-1338
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Country | US
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Telephone | 310-675-1444
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Fax | 310-675-1333
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DR. ALINE SMITH
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Credential | PH.D.
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Telephone | 310-675-1444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253J00000X
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Taxonomy Name | Foster Care Agency
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License Number |
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License Number State |
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