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NPI Code Detail

MEDICARE: SPECIAL SERVICE FOR GROUPS, INC.

MEDICARE: SPECIAL SERVICE FOR GROUPS, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0855XAdolescent and Children Mental Health Clinic/Center

General Provider Information

NPI Number : 1982735932
Entity Type Code : Organization
Provider Name (Legal Business Name) : SPECIAL SERVICE FOR GROUPS, INC.
Provider Business Mailing Address
First Line : 905 E 8TH ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90021-1848
Country : US
Telephone Number : 213-553-1800
Fax Number : 213-553-1822
Provider Business Practice Location Address
First Line : 4601 S BROADWAY FL 1
Second Line :
City : LOS ANGELES
State : CA
Zip : 90037-2729
Country : US
Telephone Number : 323-234-4445
Fax Number : 323-234-4477
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : HERBERT K HATANAKA
Credential :
Telephone Number : 213-553-1800
Provider Enumeration Date : 03/08/2007
Last Update Date : 01/30/2024

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Directions to “SPECIAL SERVICE FOR GROUPS, INC. ” Practice Location

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