Provider Demographics
NPI:1093955304
Name:KIDS FIRST FOUNDATION
Entity type:Organization
Organization Name:KIDS FIRST FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:IHAB
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAWAHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-631-7550
Mailing Address - Street 1:993C S SANTA FE AVE STE 50
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92083-6910
Mailing Address - Country:US
Mailing Address - Phone:760-631-7550
Mailing Address - Fax:760-630-5248
Practice Address - Street 1:10001 COUNTY FARM RD
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-3507
Practice Address - Country:US
Practice Address - Phone:951-343-2536
Practice Address - Fax:951-729-3309
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HIGHLANDER CHILDRENS SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-02-26
Last Update Date:2010-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA336401070251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health