Organization
DISADVANTAGED DISABLED MINORITIES FOUNDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GLENN MICHAEL MCCLEARY (EXECUTIVE DIRECTOR)
(808) 321-1807
Entity
Organization
Contact information
Practice address
20355 SHERMAN WAY CANOGA PARK, CANGO PK, CA 91306
(818) 357-8541
Mailing address
590 FARRINGTON HWY PMB 210-274, KAPOLEI, HI 96707
(808) 321-1807
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
10/13/2021
Last updated
10/13/2021
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