Provider Demographics
NPI:1861618340
Name:FREDERICK HOSKINS , INC
Entity type:Organization
Organization Name:FREDERICK HOSKINS , INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:I
Authorized Official - Last Name:HOSKINS
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:818-367-8568
Mailing Address - Street 1:PO BOX 923023
Mailing Address - Street 2:
Mailing Address - City:SYLMAR
Mailing Address - State:CA
Mailing Address - Zip Code:91392-3023
Mailing Address - Country:US
Mailing Address - Phone:818-367-8568
Mailing Address - Fax:
Practice Address - Street 1:6718 SAN RAMON DR
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90042-3037
Practice Address - Country:US
Practice Address - Phone:818-367-8568
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALTC 60594FMedicare ID - Type UnspecifiedICFDDH