Provider Demographics
NPI:1285872408
Name:BIENVENIDOS CHILDREN'S CENTER
Entity type:Organization
Organization Name:BIENVENIDOS CHILDREN'S CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:CUSACK
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:213-785-5906
Mailing Address - Street 1:316 W 2ND ST FL 8
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90012-3504
Mailing Address - Country:US
Mailing Address - Phone:213-785-5906
Mailing Address - Fax:213-785-5928
Practice Address - Street 1:255 N SAN GABRIEL BLVD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-3429
Practice Address - Country:US
Practice Address - Phone:626-696-1270
Practice Address - Fax:626-798-7899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-26
Last Update Date:2009-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health