Provider Demographics
NPI:1295854073
Name:POLINSKY CHILDREN'S CENTER
Entity Type:Organization
Organization Name:POLINSKY CHILDREN'S CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENTIAL CARE SUPERVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MYRNA
Authorized Official - Middle Name:
Authorized Official - Last Name:MURILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-967-1428
Mailing Address - Street 1:8365 BROADWAY APT 12
Mailing Address - Street 2:
Mailing Address - City:LEMON GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:91945-2038
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8365 BROADWAY #12
Practice Address - Street 2:
Practice Address - City:LEMON GROVE
Practice Address - State:CA
Practice Address - Zip Code:91945
Practice Address - Country:US
Practice Address - Phone:619-808-9342
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care