Provider Demographics
NPI:1427590389
Name:CHILDRENS INSTITUTE INC
Entity Type:Organization
Organization Name:CHILDRENS INSTITUTE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FACILITATOR
Authorized Official - Prefix:
Authorized Official - First Name:LUPE
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-355-9568
Mailing Address - Street 1:679 NEW HAMPSHIRE AVE.
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90005-1355
Mailing Address - Country:US
Mailing Address - Phone:213-807-1913
Mailing Address - Fax:
Practice Address - Street 1:679 NEW HAMPSHIRE AVE.
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90005-1355
Practice Address - Country:US
Practice Address - Phone:213-807-1913
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-09
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA91402OtherMEDICARE, UPIN, MEDICARE,PIN, MEDICARE OSCAR/CERTIFICATION, MEDICARE, NSC