Provider Demographics
NPI:1427170869
Name:SPECIAL SERVICE FOR GROUPS
Entity type:Organization
Organization Name:SPECIAL SERVICE FOR GROUPS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HERBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:HATANAKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-553-1800
Mailing Address - Street 1:605 W OLYMPIC BLVD
Mailing Address - Street 2:SUITE 600
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90015-1400
Mailing Address - Country:US
Mailing Address - Phone:213-553-1800
Mailing Address - Fax:
Practice Address - Street 1:4801 2ND AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90043-1901
Practice Address - Country:US
Practice Address - Phone:323-295-1020
Practice Address - Fax:323-298-1318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management