| Enki Youth & Family Services - West Covina | |
|
1215 W West Covina Pkwy West Covina CA 91790-2946 | |
| (626) 974-0770 | |
| (626) 974-0774 |
| Full Name | Enki Youth & Family Services - West Covina |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1215 W West Covina Pkwy, West Covina, California |
| Authorized Official Name and Position | Darren Takemoto (CFO) |
| Authorized Official Contact | 8189734899 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Enki Youth & Family Services - West Covina 150 E Olive Ave #203 Burbank CA 91502-1846 Ph: (818) 973-4899 | Enki Youth & Family Services - West Covina 1215 W West Covina Pkwy West Covina CA 91790-2946 Ph: (626) 974-0770 |
| NPI Number | 1144684721 |
|---|---|
| Provider Enumeration Date | 04/08/2016 |
| Last Update Date | 04/24/2024 |
| Certification Date | 04/24/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144684721 | NPI | - | NPPES |
| 000007977 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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