Provider Demographics
NPI:1134458797
Name:KEANY ASSOCIATES
Entity Type:Organization
Organization Name:KEANY ASSOCIATES
Other - Org Name:BRITE KIDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE/CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:KEANY
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:310-287-0382
Mailing Address - Street 1:8936 S SEPULVEDA BLVD # 200
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-3628
Mailing Address - Country:US
Mailing Address - Phone:310-287-0382
Mailing Address - Fax:310-861-5014
Practice Address - Street 1:8936 S SEPULVEDA BLVD # 200
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90045-3628
Practice Address - Country:US
Practice Address - Phone:310-287-0382
Practice Address - Fax:310-861-5014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-10
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1A-19-204251300000X
CAMFC38484251B00000X
251C00000X, 252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251300000XAgenciesLocal Education Agency (LEA)
No251B00000XAgenciesCase Management
No252Y00000XAgenciesEarly Intervention Provider Agency