Provider Demographics
NPI:1487863221
Name:SPECIAL SERVICE FOR GROUPS, INC.
Entity Type:Organization
Organization Name:SPECIAL SERVICE FOR GROUPS, INC.
Other - Org Name:SSG-PACS-LB (PACIFIC ASIAN COUNSELING SERVICES)
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HERBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:HATANAKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-553-1800
Mailing Address - Street 1:905 E 8TH ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90021-1848
Mailing Address - Country:US
Mailing Address - Phone:213-553-1800
Mailing Address - Fax:213-553-1822
Practice Address - Street 1:3530 ATLANTIC AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-4569
Practice Address - Country:US
Practice Address - Phone:562-424-1886
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health