Basic Information
| Provider Information | |||||||||
| NPI: | 1619327723 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ENKI HEALTH & RESEARCH SYSTEMS INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2523 W 7TH ST | ||||||||
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| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900573801 | ||||||||
| CountryCode: | US | ||||||||
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| Address1: | 2523 W 7TH ST | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900573801 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2134801557 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/20/2016 | ||||||||
| LastUpdateDate: | 06/20/2016 | ||||||||
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| AuthorizedOfficialLastName: | DELIFUS | ||||||||
| AuthorizedOfficialFirstName: | CHANDA | ||||||||
| AuthorizedOfficialMiddleName: | RENEE | ||||||||
| AuthorizedOfficialTitleorPosition: | MENTAL HEALTH REHABILIT SPECIALIST | ||||||||
| AuthorizedOfficialTelephone: | 3104187770 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 171M00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Case Manager/Care Coordinator |
No ID Information.