Provider Demographics
NPI:1225056864
Name:GENE M HURWIN
Entity Type:Organization
Organization Name:GENE M HURWIN
Other - Org Name:BIG FUN THERAPY AND RECREATIONAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GENE
Authorized Official - Middle Name:
Authorized Official - Last Name:HURWIN
Authorized Official - Suffix:
Authorized Official - Credentials:MA OTRL
Authorized Official - Phone:310-837-7849
Mailing Address - Street 1:3624 WESLEY ST
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90232-2435
Mailing Address - Country:US
Mailing Address - Phone:310-837-7849
Mailing Address - Fax:310-496-0512
Practice Address - Street 1:3624 WELSEY STREET
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90232-2365
Practice Address - Country:US
Practice Address - Phone:310-837-7849
Practice Address - Fax:310-496-0512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2013-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4463225X00000X
CA225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty