Provider Demographics
NPI:1760975429
Name:CHILDREN'S BUREAU LONG BEACH
Entity Type:Organization
Organization Name:CHILDREN'S BUREAU LONG BEACH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:QA ADMINISTRATIVE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LETICIA
Authorized Official - Middle Name:H
Authorized Official - Last Name:JUAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-342-0150
Mailing Address - Street 1:850 E WARDLOW RD
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-4628
Mailing Address - Country:US
Mailing Address - Phone:562-981-9392
Mailing Address - Fax:562-981-9392
Practice Address - Street 1:850 E WARDLOW RD
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-4628
Practice Address - Country:US
Practice Address - Phone:562-981-9392
Practice Address - Fax:562-981-9392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-07
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00668OtherLEGAL ENTITY