FOUNTAIN HOPE AND HEALTH FOR YOUTH (NPI# 1073873915) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073873915 |
| Entity Type | Organization |
| Organization Name | FOUNTAIN HOPE AND HEALTH FOR YOUTH |
| Practice Address |
2930 W Imperial Hwy 510 Inglewood CA 90303-3143 |
| Practice Telephone | 3237555632 |
| Practice Fax Number | 3237555630 |
| Mailing Telephone | 3237555632 |
| Mailing Fax Number | 3237555630 |
| Enumeration Date | 2012-05-25 |
| Last Update Date | 2012-05-25 |
| Authorized Official Name | ABRAHAM WALE JIMOH (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 3237555632 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDI-CAL | 0000000000 | 01 |
| Street Address |
2930 W IMPERIAL HWY 510 |
| City | INGLEWOOD |
| State | CA |
| Zip Code | 90303-3143 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639106685 | Western Imperial Medical Distributors | Durable Medical Equipment & Medical Supplies | 2930 W Imperial Hwy, Suite 200q, Inglewood, CA 90303-3143 | 2006-06-26 |
| 1427521848 | Lourdez M Zambrano | Case Manager/Care Coordinator | 2930 W Imperial Hwy, Inglewood, CA 90303-3143 | 2019-01-08 |
| 1356686935 | Charmaine M Holland | Preferred Provider Organization | 2930 W Imperial Hwy, Inglewood, CA 90303-3143 | 2012-12-07 |
| 1265798094 | Nathaniel Pumphrey | Counselor | 2930 W Imperial Hwy, 511, Inglewood, CA 90303-3143 | 2012-04-05 |
| 1427314681 | Wilbur Winston Williams | Counselor | 2930 W Imperial Hwy, 511, Inglewood, CA 90303-3143 | 2012-04-02 |
| 1659645927 | Mercedes Samudio | Counselor | 2930 W Imperial Hwy, Suite 310, Inglewood, CA 90303-3143 | 2012-03-02 |
| 1487930970 | Fiona Okereke | Registered Nurse | 2930 W Imperial Hwy, Inglewood, CA 90303-3143 | 2011-10-27 |
| 1972888386 | Danielle Joaquin Redmond | Counselor | 2930 W Imperial Hwy, Inglewood, CA 90303-3143 | 2011-10-17 |
| 1952680340 | Erik Giovanni Alvarado | Counselor | 2930 W Imperial Hwy, Suite 200m, Inglewood, CA 90303-3143 | 2011-08-16 |
| 1023308053 | Peter Singleton | Counselor | 2930 W Imperial Hwy, Inglewood, CA 90303-3143 | 2011-04-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972085983 | Jennese Bacon | Specialist/Technologist | 10932 Casimir Ave, Inglewood, CA 90303 | 2018-09-06 |
| 1174032965 | Billy Campbell | Respiratory Therapist, Registered | 11800 Lemoli Ave, Inglewood, CA 90303 | 2017-09-25 |
| 1801347307 | Michelle Adams | Social Worker | 2930 W. Imperial Hwy., Ste. 310, Inglewood, CA 90303 | 2016-10-19 |
| 1740657345 | Raiji Gaines I | Counselor | 2030 W Imperial Hwy Suite 511, Inglewood, CA 90303 | 2015-08-31 |
| 1427336221 | Aaa Dentistry Center | Dentist | 2646 West Imperial Hwy, Inglewood, CA 90303 | 2011-07-27 |
| 1275845232 | Leah Aguirre Montoya | Registered Nurse | 3451 W. Century Blvd., Suite #b-1, Inglewood, CA 90303 | 2010-07-07 |
| 1609008945 | Olawumi Rotimi | Counselor | 3211 West Imperila Hiighway, 3211 West Imperial Highway, Inglewood, CA 90303 | 2009-08-20 |
| 1568694289 | Philip Michael Bockarie | Counselor | 3211 West Imperial Highway, Inglewood, CA 90303 | 2009-08-13 |
| 1942407960 | Los Angeles Drug Treatment Center | Counselor | 3211 West Imperial Hwy, Same As Mailing Address, Inglewood, CA 90303 | 2007-07-02 |
| 1700096369 | Development Specialty Projects, Inc. | Clinic/Center | 3200 West 104 St, Ingelwood, CA 90303 | 2007-05-23 |
| Find all providers in zip 90303 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851729586 | New Hope Drug and Alcohol Treatment, Inc | Community/Behavioral Health | 115 W Kelso St, Inglewood, CA 90301-2237 | 2013-10-15 |
| 1659523918 | Heritage House of Hope, Inc. | Community/Behavioral Health | 1210 S La Brea Ave, Suite A, Inglewood, CA 90301-3891 | 2008-10-17 |
| 1700067600 | Lunns Hope Corporation | Community/Behavioral Health | 959 N La Brea Ave, Inglewood, CA 90302-2207 | 2007-11-19 |
| 1477746824 | Vista Del Mar Child and Family Services | Community/Behavioral Health | 11222 S La Cienega Blvd, Suite 115, Inglewood, CA 90304-1109 | 2007-08-20 |
| 1518086834 | Multicultural Counseling Service Center, Inc. | Community/Behavioral Health | 9800 S La Cienega Blvd, Ste. 310, Inglewood, CA 90301-4440 | 2007-03-28 |
| 1083732671 | Faithful Central Bible Church | Community/Behavioral Health | 333 W Florence Ave, Inglewood, CA 90301-1103 | 2007-03-26 |
| 1912037797 | Behavioral Health Services | Community/Behavioral Health | 404 Edgewood St, Inglewood, CA 90302-3415 | 2007-03-07 |
| 1558977082 | Didi Hirsch Psychiatric Service | Community/Behavioral Health | 231 S Grevillea Ave, Inglewood, CA 90301-2323 | 2020-09-21 |
| 1508481771 | Didi Hirsch Psychiatric Service | Community/Behavioral Health | 809 E Kelso St, Inglewood, CA 90301-2809 | 2020-06-12 |
| 1376014134 | Seneca Family of Agencies | Community/Behavioral Health | 1506 Centinela Ave, Inglewood, CA 90302-1144 | 2018-12-05 |
| Find all providers in INGLEWOOD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.