Provider Demographics
NPI:1891050654
Name:HELPING KIDS TO RECOVER, INC.
Entity Type:Organization
Organization Name:HELPING KIDS TO RECOVER, INC.
Other - Org Name:SOLEDAD ENRICHMENT ACTION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CHYNETHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOYD
Authorized Official - Suffix:
Authorized Official - Credentials:MBA, RAS
Authorized Official - Phone:3102-170-6165
Mailing Address - Street 1:637 E ALBERTONI ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90746-1539
Mailing Address - Country:US
Mailing Address - Phone:310-217-0616
Mailing Address - Fax:310-217-0545
Practice Address - Street 1:1705 N CULVER AVE
Practice Address - Street 2:
Practice Address - City:COMPTON
Practice Address - State:CA
Practice Address - Zip Code:90222-2905
Practice Address - Country:US
Practice Address - Phone:310-217-0616
Practice Address - Fax:310-217-0545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-09
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA197247Medicaid