Provider Demographics
NPI: | 1629407440 |
---|---|
Name: | THE WHOLE CHILD - MENTAL HEALTH & HOUSING SERVICES |
Entity Type: | Organization |
Organization Name: | THE WHOLE CHILD - MENTAL HEALTH & HOUSING SERVICES |
Other - Org Name: | BIRTH TO FIVE CENTER |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | CFO |
Authorized Official - Prefix: | |
Authorized Official - First Name: | STACY |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | ENOMOTO |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 562-692-0383 |
Mailing Address - Street 1: | 10155 COLIMA RD |
Mailing Address - Street 2: | |
Mailing Address - City: | WHITTIER |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 90603-2042 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 562-692-0383 |
Mailing Address - Fax: | 562-692-0380 |
Practice Address - Street 1: | 12225 BEVERLY BLVD |
Practice Address - Street 2: | |
Practice Address - City: | WHITTIER |
Practice Address - State: | CA |
Practice Address - Zip Code: | 90601-2966 |
Practice Address - Country: | US |
Practice Address - Phone: | 562-692-0383 |
Practice Address - Fax: | 562-692-0380 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | THE WHOLE CHILD |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2013-11-02 |
Last Update Date: | 2017-09-21 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 251S00000X | Agencies | Community/Behavioral Health |