Provider Demographics
NPI:1669968426
Name:DANGERFIELD INSTITUTE
Entity type:Organization
Organization Name:DANGERFIELD INSTITUTE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LORRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:IRVING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-290-5058
Mailing Address - Street 1:4736 11TH AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90043-5437
Mailing Address - Country:US
Mailing Address - Phone:323-290-5054
Mailing Address - Fax:323-299-7160
Practice Address - Street 1:4736 11TH AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90043-5437
Practice Address - Country:US
Practice Address - Phone:323-290-5054
Practice Address - Fax:323-799-7160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-05
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA253J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency