Provider Demographics
NPI:1427500263
Name:ENKI HEALTH SERVICES, INC
Entity type:Organization
Organization Name:ENKI HEALTH SERVICES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:DARREN
Authorized Official - Middle Name:
Authorized Official - Last Name:TAKEMOTO
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:818-973-4899
Mailing Address - Street 1:150 E OLIVE AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91502-1849
Mailing Address - Country:US
Mailing Address - Phone:818-973-4899
Mailing Address - Fax:818-973-4888
Practice Address - Street 1:5100 S EASTERN AVE STE 100
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90040-2964
Practice Address - Country:US
Practice Address - Phone:323-647-6740
Practice Address - Fax:562-334-3518
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-27
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000001912Medicaid