Provider Demographics
NPI:1447381991
Name:ENKI HEALTH & RESEARCH SYSTEMS, INC.
Entity Type:Organization
Organization Name:ENKI HEALTH & RESEARCH SYSTEMS, INC.
Other - Org Name:ENKI YOUTH & FAMILY SERVICES-COVINA
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT-COO
Authorized Official - Prefix:MR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:W
Authorized Official - Last Name:URMER
Authorized Official - Suffix:
Authorized Official - Credentials:MHS
Authorized Official - Phone:818-973-4899
Mailing Address - Street 1:150 E OLIVE AVE
Mailing Address - Street 2:#203
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91502-1846
Mailing Address - Country:US
Mailing Address - Phone:818-973-4899
Mailing Address - Fax:818-973-4888
Practice Address - Street 1:535 S 2ND AVE
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91723-3013
Practice Address - Country:US
Practice Address - Phone:626-974-0770
Practice Address - Fax:626-974-0774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000007258Medicaid