Provider Demographics
NPI:1386189785
Name:DEFINITELY LEARNING CHILDREN PROGRAM
Entity Type:Organization
Organization Name:DEFINITELY LEARNING CHILDREN PROGRAM
Other - Org Name:DEFINITELY LEARNING INFANT AND PRESCHOOL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROGRAM ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JACQUELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-423-5106
Mailing Address - Street 1:3130 W VERNON AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90008-5226
Mailing Address - Country:US
Mailing Address - Phone:323-389-8024
Mailing Address - Fax:
Practice Address - Street 1:3130 W VERNON AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90008-5226
Practice Address - Country:US
Practice Address - Phone:323-389-8024
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-21
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No251E00000XAgenciesHome Health