Provider Demographics
NPI:1811454218
Name:THE PUPPY WATER ENTERTAINMENT FOUNDATION
Entity type:Organization
Organization Name:THE PUPPY WATER ENTERTAINMENT FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PRINCESS
Authorized Official - Middle Name:
Authorized Official - Last Name:OKIEME
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:424-279-3898
Mailing Address - Street 1:609 DEEP VALLEY DR STE 200-057
Mailing Address - Street 2:
Mailing Address - City:ROLLING HILLS ESTATES
Mailing Address - State:CA
Mailing Address - Zip Code:90274-3629
Mailing Address - Country:US
Mailing Address - Phone:424-279-3898
Mailing Address - Fax:949-695-3114
Practice Address - Street 1:609 DEEP VALLEY DR # 200057
Practice Address - Street 2:
Practice Address - City:ROLLING HILLS ESTATES
Practice Address - State:CA
Practice Address - Zip Code:90274-3629
Practice Address - Country:US
Practice Address - Phone:424-279-3898
Practice Address - Fax:949-695-3114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-22
Last Update Date:2024-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No251300000XAgenciesLocal Education Agency (LEA)Group - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)