Provider Demographics
NPI:1992468854
Name:MY ABC ENTERPRISES, LLC
Entity Type:Organization
Organization Name:MY ABC ENTERPRISES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LENETTE
Authorized Official - Middle Name:LORETO
Authorized Official - Last Name:BELEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-814-8149
Mailing Address - Street 1:1735 W FERN DR
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92833-2334
Mailing Address - Country:US
Mailing Address - Phone:714-814-8149
Mailing Address - Fax:714-582-2538
Practice Address - Street 1:1735 W FERN DR
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92833-2334
Practice Address - Country:US
Practice Address - Phone:714-814-8149
Practice Address - Fax:714-582-2538
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-18
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services