Provider Demographics
NPI:1700116209
Name:HELPING KIDS TO RECOVER, INC.
Entity Type:Organization
Organization Name:HELPING KIDS TO RECOVER, INC.
Other - Org Name:CENTINNIAL HIGH SCHOOL
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
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:310-217-0616
Mailing Address - Street 1:637 E. ALBERTONI ST.
Mailing Address - Street 2:STE. 200
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90746
Mailing Address - Country:US
Mailing Address - Phone:310-217-0616
Mailing Address - Fax:310-217-0545
Practice Address - Street 1:2606 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:COMPTON
Practice Address - State:CA
Practice Address - Zip Code:90222-1640
Practice Address - Country:US
Practice Address - Phone:310-217-0616
Practice Address - Fax:310-217-0545
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HELPING KIDS TO RECOVER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-01-05
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA197247Medicaid