Organization
CAREPROVIDER ORG FOUNDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHIKA DILLIBE (EXECUTIVE DIRECTOR)
(626) 967-1105
Entity
Organization
Contact information
Practice address
281 E WORKMAN ST STE 203, COVINA, CA 91723-3566
(626) 967-1105
(626) 967-1107
Mailing address
281 E WORKMAN ST STE 203, COVINA, CA 91723-3566
(626) 967-1105
(626) 967-1107
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1568913580
NPPES
CA
01
—
1568913887
NPPES
CA
01
—
1942751268
NPPES
CA
Enumeration date
02/22/2019
Last updated
02/22/2019
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