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Organization
OPTIMIST BOYS' HOME AND RANCH, INC.
Active
Organization
OPTIMIST BOYS' HOME AND RANCH, INC.
Active
Other names
Optimist Campus
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BLYTHE COTTON MALING (CHIEF EXECUTIVE OFFICER)
(323) 443-3101
Entity
Organization
Contact information
Practice address
6957 N FIGUEROA ST, LOS ANGELES, CA 90042-1245
(323) 443-3175
(323) 344-5124
Mailing address
6957 N FIGUEROA ST, LOS ANGELES, CA 90042-1245
(323) 443-3175
(323) 344-5124
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00781
MEDI-CAL PROVIDER
CA
Enumeration date
11/22/2016
Last updated
07/08/2026
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