Provider Demographics
NPI:1801528773
Name:SHAPE 4 FAMILIES INC.
Entity type:Organization
Organization Name:SHAPE 4 FAMILIES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY/ TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:KARL
Authorized Official - Middle Name:
Authorized Official - Last Name:STENSKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-922-1115
Mailing Address - Street 1:18 TECHNOLOGY DR STE 118
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-2310
Mailing Address - Country:US
Mailing Address - Phone:949-922-1115
Mailing Address - Fax:
Practice Address - Street 1:18 TECHNOLOGY DR STE 118
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-2310
Practice Address - Country:US
Practice Address - Phone:949-922-1115
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-28
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health