Provider Demographics
NPI:1205546330
Name:LEE AND KIM FAMILY INC
Entity type:Organization
Organization Name:LEE AND KIM FAMILY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER - CLINICAL
Authorized Official - Prefix:
Authorized Official - First Name:JONGHYEOK
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:213-331-7774
Mailing Address - Street 1:5451 TWIN LAKES DR
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90630-5945
Mailing Address - Country:US
Mailing Address - Phone:213-331-7774
Mailing Address - Fax:
Practice Address - Street 1:5451 TWIN LAKES DR
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:CA
Practice Address - Zip Code:90630-5945
Practice Address - Country:US
Practice Address - Phone:213-331-7774
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-30
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty