Provider Demographics
NPI:1023380185
Name:HANNAS HOUSE INC
Entity Type:Organization
Organization Name:HANNAS HOUSE INC
Other - Org Name:HANNAHS FIRST STEP TREATMENT CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-278-6501
Mailing Address - Street 1:5900 S EASTERN AVE
Mailing Address - Street 2:142
Mailing Address - City:COMMERCE
Mailing Address - State:CA
Mailing Address - Zip Code:90040-4017
Mailing Address - Country:US
Mailing Address - Phone:323-278-6501
Mailing Address - Fax:
Practice Address - Street 1:5900 S EASTERN AVE
Practice Address - Street 2:142
Practice Address - City:COMMERCE
Practice Address - State:CA
Practice Address - Zip Code:90040-4017
Practice Address - Country:US
Practice Address - Phone:323-278-6501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-06
Last Update Date:2012-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA7428Medicaid