Provider Demographics
NPI:1720111297
Name:DIDI HIRSCH
Entity Type:Organization
Organization Name:DIDI HIRSCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROD
Authorized Official - Middle Name:A
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:562-634-7111
Mailing Address - Street 1:14005 ARTHUR AVE APT 10
Mailing Address - Street 2:
Mailing Address - City:PARAMOUNT
Mailing Address - State:CA
Mailing Address - Zip Code:90723-2270
Mailing Address - Country:US
Mailing Address - Phone:562-634-7111
Mailing Address - Fax:562-634-7111
Practice Address - Street 1:1007 MYRTLE AVE
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90301-4009
Practice Address - Country:US
Practice Address - Phone:310-412-4191
Practice Address - Fax:310-412-3942
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA32Other32