Provider Demographics
NPI:1154649564
Name:D'VEAL FAMILY AND YOUTH SERVICES
Entity Type:Organization
Organization Name:D'VEAL FAMILY AND YOUTH SERVICES
Other - Org Name:D'VEAL FAM & YTH JOHN MUIR HIGH SCH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/D'VEAL FAMILY & YOUTH SERVICES
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:T
Authorized Official - Last Name:MCCALL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:626-794-3136
Mailing Address - Street 1:PO BOX 40255
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91114-7255
Mailing Address - Country:US
Mailing Address - Phone:626-296-8900
Mailing Address - Fax:626-296-8910
Practice Address - Street 1:1905 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91103-1315
Practice Address - Country:US
Practice Address - Phone:626-396-5600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-10
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health