Organization
ADJUSTED SITUATIONS FOR ALL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICO HAWKINS (PRESIDENT)
(661) 409-5631
Entity
Organization
Contact information
Practice address
44616 FIG AVE, LANCASTER, CA 93534-3415
(661) 373-8792
Mailing address
44616 FIG AVE, LANCASTER, CA 93534-3415
(661) 373-8792
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
—
—
174200000X
Meals Provider
—
—
251B00000X
Case Management Agency
—
—
251X00000X
Supports Brokerage Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
310400000X
Assisted Living Facility
—
—
332U00000X
Home Delivered Meals
—
—
342000000X
Transportation Network Company
—
—
347C00000X
Private Vehicle
—
—
347E00000X
Transportation Broker
—
—
385H00000X
Respite Care
—
—
385HR2055X
Child Mental Illness Respite Care
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
385HR2065X
Child Physical Disabilities Respite Care
—
—
Other
Enumeration date
12/19/2022
Last updated
12/19/2022
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