Provider Demographics
NPI:1578990644
Name:HIS GIFTS INC
Entity Type:Organization
Organization Name:HIS GIFTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:MARTREICE
Authorized Official - Last Name:FERGUSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-420-3512
Mailing Address - Street 1:12204 SOUTH SAN PEDRO STREET LOS ANGELES, CA 90061
Mailing Address - Street 2:10910 LONG BEACH BLVD STE 103
Mailing Address - City:LYNWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90262
Mailing Address - Country:US
Mailing Address - Phone:310-420-3512
Mailing Address - Fax:
Practice Address - Street 1:12204 SOUTH SAN PEDRO STREET LOS ANGELES, CA 90061
Practice Address - Street 2:10910 LONG BEACH BLVD SUITE 103
Practice Address - City:LYNWOOD
Practice Address - State:CA
Practice Address - Zip Code:90262
Practice Address - Country:US
Practice Address - Phone:310-420-3512
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-03
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS14553251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health