DELIANN-LUCILE CORPORATION (NPI# 1629511670) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629511670 |
| Entity Type | Organization |
| Organization Name | DELIANN-LUCILE CORPORATION |
| Other Organization Name | DELILU ACHIEVEMENT HOME 3 |
| Practice Address |
5739 Chesley Ave Los Angeles CA 90043-2423 |
| Mailing Address |
5731 W Slauson Ave Ste 210 Culver City CA 90230-6982 |
| Practice Telephone | 3232990822 |
| Practice Fax Number | 3232990819 |
| Mailing Telephone | 3102158900 |
| Mailing Fax Number | 3102158907 |
| Enumeration Date | 2016-11-23 |
| Last Update Date | 2019-12-16 |
| Authorized Official Name | MARY L DAVIS (CEO) |
| Authorized Official Telephone | 3102158900 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| DeliLu Achievement Home #3 | Doing Business As Name - Organization |
| DeliLu Achievement Home #3 | Other Name - Individual/Organization |
| DeliLu Achievement Home 3 | Other Name - Individual/Organization |
| DeliLu Achievemnt Home #3 | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992266134 | Deliann-lucile Corporation | Residential Treatment Facility, Emotionally Disturbed Children | 5731 W Slauson Ave Ste 210, Culver City, CA 90230-6982 | 2019-03-29 |
| 1245773290 | Deliann-lucile Corporation | Residential Treatment Facility, Emotionally Disturbed Children | 1564 W 36th Pl, Los Angeles, CA 90018-4503 | 2016-11-23 |
| 1982147922 | Deliann-lucile Corporation | Residential Treatment Facility, Emotionally Disturbed Children | 2122 W 107th St, Los Angeles, CA 90047-4305 | 2016-11-23 |
| 1922548932 | Deliann-lucile Corporation | Residential Treatment Facility, Emotionally Disturbed Children | 1564 W 36th Pl, Los Angeles, CA 90018-4503 | 2017-02-24 |
| Street Address |
5739 CHESLEY AVE |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90043-2423 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790011443 | Velvetta Salary | Counselor | 5739 Chesley Ave, Los Angeles, CA 90043-2423 | 2009-10-29 |
| 1063068021 | Tawana Snowden | Case Manager/Care Coordinator | 5739 Chesley Ave, Los Angeles, CA 90043-2423 | 2019-08-15 |
| 1235785296 | Lauren Lang | Case Manager/Care Coordinator | 5739 Chesley Ave, Los Angeles, CA 90043-2423 | 2019-08-15 |
| 1174179139 | Paqueta Davis | Case Manager/Care Coordinator | 5739 Chesley Ave, Los Angeles, CA 90043-2423 | 2019-08-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841772209 | Ichizo Yamada | Counselor | 5318 S Crenshaw Blvd., Los Angeles, CA 90043 | 2018-09-02 |
| 1568961613 | Marnelle Mascardo | Counselor | 5318 S. Crenshaw Blvd., Los Angeles, CA 90043 | 2018-02-05 |
| 1700315199 | Positive Imagery Foundation | Prevention Professional | 5906 7th Avenue, Suite 1, Los Angeles, CA 90043 | 2017-06-08 |
| 1770946303 | Toby Lapesarde | Licensed Vocational Nurse | 5300 Angeles Vista Boulevard, Los Angeles, CA 90043 | 2016-03-31 |
| 1134591480 | Coast Wise Solution | Case Management | 2728 54th St, Los Angeles, CA 90043 | 2015-10-27 |
| 1033589155 | Nina Gonzaga | Marriage & Family Therapist | 4401 Crendshaw Blvd, #300, Los Angeles, CA 90043 | 2015-10-01 |
| 1861743189 | Donna M. Tizenor-tate | Counselor | 5300 Angeles Vista Blvd., Los Angeles, CA 90043 | 2012-09-26 |
| 1952657736 | Willie Frank Sibley Jr. | General Practice | 4330 Monteith Dr, Los Angeles, CA 90043 | 2012-07-30 |
| 1639449119 | Nelson M Okeke | Counselor | 8814 S. Western Ave, La, CA 90043 | 2011-12-30 |
| 1578840799 | Economic Services, Incorporated | Exclusive Provider Organization | 5144 Crenshaw Blvd., Los Angeles, CA 90043 | 2011-11-16 |
| Find all providers in zip 90043 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457863706 | The Dream Catcher Foundation, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 1537 W 49th St, Los Angeles, CA 90062 | 2017-10-26 |
| 1083125603 | The Dream Catcher Foundation, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 3601 2nd Ave, Los Angeles, CA 90018 | 2017-10-23 |
| 1710498332 | The Dream Catcher Foundation, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 4173 2nd Ave, Los Angeles, CA 90008 | 2017-10-23 |
| 1639680259 | The Dream Catcher Foundation, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 1762 W 42nd St, Los Angeles, CA 90062 | 2017-10-23 |
| 1780129486 | Los Angeles Youth Network | Residential Treatment Facility, Emotionally Disturbed Children | 2471 N Beachwood Dr, Los Angeles, CA 90068-3004 | 2017-01-04 |
| 1245773290 | Deliann-lucile Corporation | Residential Treatment Facility, Emotionally Disturbed Children | 1564 W 36th Pl, Los Angeles, CA 90018-4503 | 2016-11-23 |
| 1982147922 | Deliann-lucile Corporation | Residential Treatment Facility, Emotionally Disturbed Children | 2122 W 107th St, Los Angeles, CA 90047-4305 | 2016-11-23 |
| 1306395454 | Deliann-lucile | Residential Treatment Facility, Emotionally Disturbed Children | 5800 Hannum Ave Ste 230, Los Angeles, CA 90230-6553 | 2016-09-30 |
| 1619400330 | Hamburger Home | Residential Treatment Facility, Emotionally Disturbed Children | 1701 Camino Palmero St, Los Angeles, CA 90046-2902 | 2017-04-10 |
| 1922548932 | Deliann-lucile Corporation | Residential Treatment Facility, Emotionally Disturbed Children | 1564 W 36th Pl, Los Angeles, CA 90018-4503 | 2017-02-24 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90043 |
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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.