Provider Demographics
NPI:1477868008
Name:ICEC
Entity Type:Organization
Organization Name:ICEC
Other - Org Name:INTERVENTION CENTER FOR EARLY CHILDHOOD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:B
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-857-0255
Mailing Address - Street 1:17461 DERIAN AVE
Mailing Address - Street 2:SUITE 114
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92614-5843
Mailing Address - Country:US
Mailing Address - Phone:949-788-9236
Mailing Address - Fax:949-788-9246
Practice Address - Street 1:17461 DERIAN AVE
Practice Address - Street 2:SUITE 114
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92614-5843
Practice Address - Country:US
Practice Address - Phone:949-788-9236
Practice Address - Fax:949-788-9246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-06
Last Update Date:2015-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty