Organization · NPI-2

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Psychiatric Residential Treatment Facility · Los Angeles, CA

NPI number1780967406
StatusActive
Last updated in NPPESAug 12, 2020

Details

NPI
1780967406
Entity type
Organization (NPI-2)
Legal business name
Hamburger Home
Organization subpart
No
Enumeration date
Sep 20, 2011
Certification date
Aug 12, 2020
Last updated
Aug 12, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
323P00000X Psychiatric Residential Treatment Facilityvn251427CAYes

Other names

  • Aviva Family And Children'S Services (Doing Business As)

Practice location

1701 Camino Palmero St
Los Angeles, CA 90046-2902

Phone 323-876-0550 · Fax 323-876-0439

Mailing address

1701 Camino Palmero St
Los Angeles, CA 90046-2902

Phone 323-876-0550 · Fax 323-876-0439

Authorized official

Regina Bette
President/Ceo
3238760550

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