Basic Information
| Provider Information | |||||||||
| NPI: | 1932473022 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | WAYFINDER FAMILY SERVICES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5300 ANGELES VISTA BLVD | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900431648 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3232954555 | ||||||||
| FaxNumber: | 3235080150 | ||||||||
| Practice Location | |||||||||
| Address1: | 5300 ANGELES VISTA BLVD | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900431648 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3232954555 | ||||||||
| FaxNumber: | 3235080150 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/07/2012 | ||||||||
| LastUpdateDate: | 06/11/2020 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | JORDAN | ||||||||
| AuthorizedOfficialFirstName: | MIKI | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT/CEO | ||||||||
| AuthorizedOfficialTelephone: | 3232954555 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| NPICertificationDate: | 06/11/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 322D00000X | N | Residential Treatment Facilities | Residential Treatment Facility, Emotionally Disturbed Children | 251S00000X | Y | Agencies | Community/Behavioral Health |
No ID Information.