Basic Information
| Provider Information | |||||||||
| NPI: | 1760940480 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FLEMING & BARNES, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 4446 | ||||||||
| Address2: | |||||||||
| City: | PALOS VERDES PENINSULA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902749595 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3107913064 | ||||||||
| FaxNumber: | 3107913084 | ||||||||
| Practice Location | |||||||||
| Address1: | 23860 HAWTHORNE BLVD STE 200 | ||||||||
| Address2: | |||||||||
| City: | TORRANCE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 905058201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3107913064 | ||||||||
| FaxNumber: | 3107913084 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/12/2019 | ||||||||
| LastUpdateDate: | 05/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | FLEMING | ||||||||
| AuthorizedOfficialFirstName: | KEN | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 3107913064 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | FLEMING & BARNES, INC. | ||||||||
| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| NPICertificationDate: | 05/22/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 322D00000X | Y | Residential Treatment Facilities | Residential Treatment Facility, Emotionally Disturbed Children |
No ID Information.