Organization
MOLDING HEARTS ORG
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LAKITA T JOHNSON (CEO)
(951) 464-8587
Entity
Organization
Contact information
Practice address
6805 PRESCOTT AVE, YUCCA VALLEY, CA 92284-5914
(951) 464-8587
Mailing address
6805 PRESCOTT AVE, YUCCA VALLEY, CA 92284-5914
(951) 464-8587
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
251V00000X
Voluntary or Charitable Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
06/14/2024
Last updated
06/14/2024
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