Provider Demographics
NPI:1144571290
Name:DARE U TO CARE OUTREACH MINISTRIES
Entity Type:Organization
Organization Name:DARE U TO CARE OUTREACH MINISTRIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-777-2372
Mailing Address - Street 1:316 W 120TH ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90061-1306
Mailing Address - Country:US
Mailing Address - Phone:323-777-2372
Mailing Address - Fax:323-777-2488
Practice Address - Street 1:316 W 120TH ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90061-1306
Practice Address - Country:US
Practice Address - Phone:323-777-2372
Practice Address - Fax:323-777-2488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-28
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA190182BN251C00000X, 305S00000X, 324500000X, 3245S0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No305S00000XManaged Care OrganizationsPoint of Service
No3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA316DUTCMedicaid