Provider Demographics
NPI:1073643292
Name:HAMBURGER HOME
Entity Type:Organization
Organization Name:HAMBURGER HOME
Other - Org Name:AVIVA FAMILY AND CHILDREN'S SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF PROGRAMS & SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:LABBE
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:323-876-0550
Mailing Address - Street 1:3580 WILSHIRE BLVD
Mailing Address - Street 2:STE 800
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010-2501
Mailing Address - Country:US
Mailing Address - Phone:323-876-0550
Mailing Address - Fax:213-637-5001
Practice Address - Street 1:5805 SEPULVEDA BLVD STE 710
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91411-2522
Practice Address - Country:US
Practice Address - Phone:818-980-3200
Practice Address - Fax:818-980-3203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health