Basic Information
| Provider Information | |||||||||
| NPI: | 1639391410 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | SPECIAL SERVICE FOR GROUPS, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 905 E 8TH ST | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900211848 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2135531800 | ||||||||
| FaxNumber: | 2135531822 | ||||||||
| Practice Location | |||||||||
| Address1: | 515 COLUMBIA AVE STE 310 | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900171209 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2133681888 | ||||||||
| FaxNumber: | 2133686888 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/02/2007 | ||||||||
| LastUpdateDate: | 10/17/2022 | ||||||||
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| AuthorizedOfficialLastName: | HATANAKA | ||||||||
| AuthorizedOfficialFirstName: | HERBERT | ||||||||
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| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 2135531800 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 10/17/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | Y | Agencies | Community/Behavioral Health |
No ID Information.