Provider Demographics
NPI:1629571104
Name:DAUGHTER PROJECT GIRLS HOME
Entity Type:Organization
Organization Name:DAUGHTER PROJECT GIRLS HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER AND EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:JENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-213-3380
Mailing Address - Street 1:PO BOX 13160
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93389-3160
Mailing Address - Country:US
Mailing Address - Phone:661-213-3380
Mailing Address - Fax:
Practice Address - Street 1:3535 UNION AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93305-2937
Practice Address - Country:US
Practice Address - Phone:661-213-3380
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GLOBAL FAMILY CARE NETWORK, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-03-12
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA157806794OtherFACILITY LICENSE