Provider Demographics
NPI:1093241309
Name:HAMBURGER HOME
Entity Type:Organization
Organization Name:HAMBURGER HOME
Other - Org Name:AVIVA FAMILY & CHILDREN'S SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR, SCHOOL-BASED SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:LANDEFELD
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:213-637-5000
Mailing Address - Street 1:3580 WILSHIRE BLVD
Mailing Address - Street 2:800
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010-2501
Mailing Address - Country:US
Mailing Address - Phone:213-637-5000
Mailing Address - Fax:213-637-5001
Practice Address - Street 1:4066 W. 17TH STREET
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90019
Practice Address - Country:US
Practice Address - Phone:323-730-4300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-05
Last Update Date:2017-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health