Provider Demographics
NPI:1386883817
Name:VILLAGE FAMILY SERVICES
Entity type:Organization
Organization Name:VILLAGE FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CASE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:ANNETTE
Authorized Official - Last Name:GUSTAVE-MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-248-3516
Mailing Address - Street 1:16718 NICKLAUS DR UNIT 60
Mailing Address - Street 2:
Mailing Address - City:SYLMAR
Mailing Address - State:CA
Mailing Address - Zip Code:91342-1675
Mailing Address - Country:US
Mailing Address - Phone:213-248-3516
Mailing Address - Fax:
Practice Address - Street 1:6736 LAUREL CANYON BLVD STE 200
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-1576
Practice Address - Country:US
Practice Address - Phone:818-755-8786
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-06
Last Update Date:2009-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management