Provider Demographics
NPI:1528368735
Name:SOCIAL SERVICE PROFESSIONALS
Entity Type:Organization
Organization Name:SOCIAL SERVICE PROFESSIONALS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:STERN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-473-4448
Mailing Address - Street 1:11835 W. OLYMPIC LVD.,
Mailing Address - Street 2:STE. 1090
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064
Mailing Address - Country:US
Mailing Address - Phone:310-473-4448
Mailing Address - Fax:
Practice Address - Street 1:6938 LAUREL CANYON BLVD.,
Practice Address - Street 2:UNIT 316
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91605
Practice Address - Country:US
Practice Address - Phone:310-497-3718
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-22
Last Update Date:2010-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251S00000X, 282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No251S00000XAgenciesCommunity/Behavioral Health