Provider Demographics
NPI:1558957878
Name:KIDS TO KIDS
Entity Type:Organization
Organization Name:KIDS TO KIDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:YASUTAKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-896-6192
Mailing Address - Street 1:PO BOX 2796
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93002-2796
Mailing Address - Country:US
Mailing Address - Phone:805-896-6192
Mailing Address - Fax:
Practice Address - Street 1:496 HOWARD ST
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-4533
Practice Address - Country:US
Practice Address - Phone:805-643-1900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-21
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children