Organization
SHOUP GROUP HOME
Active
Parent organization
CHILDREN'S HOMES OF SOUTHERN CALIFORNIA
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHILDREN'S HOMES OF SOUTHERN CALIFORNIA
Authorized official
MR. JORGE C MARQUEZ (EXECUTIVE DIRECTOR)
(818) 592-2960
Entity
Organization
Contact information
Practice address
6450 SHOUP AVENUE, WOODLAND HILLS, CA 91307
(818) 347-3839
(818) 347-3839
Mailing address
22455 VICTORY BLVD, WEST HILLS, CA 91307
(818) 592-2960
(818) 592-2961
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
197601995
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
197601995
DEPARTMENT OF SOCIAL SERVICES
CA
Enumeration date
09/01/2016
Last updated
09/01/2016
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