1194063958 NPI number — THE VILLAGE FAMILY SERVICES, INC.

Table of content: (NPI 1194063958)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194063958 NPI number — THE VILLAGE FAMILY SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE VILLAGE FAMILY SERVICES, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
THE VILLAGE FAMILY SERVICES
Provider Other Organization Name Type Code:
4
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1194063958
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/30/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6736 LAUREL CANYON BLVD STE 200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTH HOLLYWOOD
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91606-1576
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
818-755-8786
Provider Business Mailing Address Fax Number:
818-755-8789

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6801 COLDWATER CANYON AVE
Provider Second Line Business Practice Location Address:
SUITE 1E
Provider Business Practice Location Address City Name:
NORTH HOLLYWOOD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91605-5167
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-755-8786
Provider Business Practice Location Address Fax Number:
818-755-8789
Provider Enumeration Date:
01/29/2013

Additional Information

Authorized Official

Authorized Official Last Name:
BOWEN
Authorized Official First Name:
HEATHER
Authorized Official Middle Name:
Authorized Official Title or Position:
SR. DIRECTOR COMPLIANCE & RISK MGMT
Authorized Official Telephone Number:
818-755-8786

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  197805014 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com