Provider Demographics
NPI:1063853851
Name:SECURE TRANSITIONS FOSTER FAMILY AGENCY
Entity Type:Organization
Organization Name:SECURE TRANSITIONS FOSTER FAMILY AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MELVIN
Authorized Official - Middle Name:MADERO
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-342-3950
Mailing Address - Street 1:5711 W SLAUSON AVE
Mailing Address - Street 2:SUITE 250
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-6532
Mailing Address - Country:US
Mailing Address - Phone:310-342-3950
Mailing Address - Fax:310-342-3955
Practice Address - Street 1:5711 W SLAUSON AVE
Practice Address - Street 2:SUITE 250
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-6532
Practice Address - Country:US
Practice Address - Phone:310-342-3950
Practice Address - Fax:310-342-3955
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-10
Last Update Date:2013-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA197805486253J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency