Provider Demographics
NPI:1821316969
Name:PENNY LANE CENTERS
Entity Type:Organization
Organization Name:PENNY LANE CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHILD AND FAMILY SPECIALIST
Authorized Official - Prefix:MS
Authorized Official - First Name:ALEXANDRIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:REDFIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-266-4783
Mailing Address - Street 1:43520 DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93535-4089
Mailing Address - Country:US
Mailing Address - Phone:661-266-4783
Mailing Address - Fax:661-266-1210
Practice Address - Street 1:43520 DIVISION ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93535-4089
Practice Address - Country:US
Practice Address - Phone:661-266-4783
Practice Address - Fax:661-266-1210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-13
Last Update Date:2010-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management