Provider Demographics
NPI:1710565262
Name:ACTIVITIES FOR RETARDED CHILDREN
Entity Type:Organization
Organization Name:ACTIVITIES FOR RETARDED CHILDREN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PROGRAMS
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROLE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:818-762-4365
Mailing Address - Street 1:6456 WHITSETT AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91606-2322
Mailing Address - Country:US
Mailing Address - Phone:818-762-4365
Mailing Address - Fax:818-762-1048
Practice Address - Street 1:6456 WHITSETT AVE
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-2322
Practice Address - Country:US
Practice Address - Phone:818-762-4365
Practice Address - Fax:818-762-1048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-29
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility