Provider Demographics
NPI:1578224002
Name:SPECIAL SERVICE FOR GROUPS, INC.
Entity Type:Organization
Organization Name:SPECIAL SERVICE FOR GROUPS, INC.
Other - Org Name:SSG HOPICS CROCKER
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HERBERT
Authorized Official - Middle Name:K
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 1:5849 CROCKER ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90003-1311
Practice Address - Country:US
Practice Address - Phone:323-432-4399
Practice Address - Fax:323-432-4398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-06
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251X00000XAgenciesSupports Brokerage