DELIANN-LUCILE CORPORATION (NPI# 1982147922) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982147922 |
| Entity Type | Organization |
| Organization Name | DELIANN-LUCILE CORPORATION |
| Other Organization Name | DELILU ACHIEVEMENT HOME 2 |
| Practice Address |
2122 W 107th St Los Angeles CA 90047-4305 |
| Mailing Address |
5731 W Slauson Ave Ste 210 Culver City CA 90230-6982 |
| Practice Telephone | 3236969749 |
| Practice Fax Number | 3236969508 |
| 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 #2 | Doing Business As Name - Organization |
| DeliLu Achievement Home #2 | Other Name - Individual/Organization |
| DeliLu Achievement Home 2 | Other Name - Individual/Organization |
| DeliLu Achievement Home II | 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 |
| 1922548932 | Deliann-lucile Corporation | Residential Treatment Facility, Emotionally Disturbed Children | 1564 W 36th Pl, Los Angeles, CA 90018-4503 | 2017-02-24 |
| 1629511670 | Deliann-lucile Corporation | Residential Treatment Facility, Emotionally Disturbed Children | 5739 Chesley Ave, Los Angeles, CA 90043-2423 | 2016-11-23 |
| Street Address |
2122 W 107TH ST |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90047-4305 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497302483 | Alma Bocanegra | Case Manager/Care Coordinator | 2122 W 107th St, Los Angeles, CA 90047-4305 | 2019-08-23 |
| 1861049850 | Donnetia Mayers | Case Manager/Care Coordinator | 2122 W 107th St, Los Angeles, CA 90047-4305 | 2019-08-23 |
| 1184270092 | Jameka Johnson | Case Manager/Care Coordinator | 2122 W 107th St, Los Angeles, CA 90047-4305 | 2019-08-15 |
| 1174179089 | Stefani Lipsey | Case Manager/Care Coordinator | 2122 W 107th St, Los Angeles, CA 90047-4305 | 2019-08-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063071652 | Cherae Nikia Stovall | Counselor | 1704 Manchester Boulevard, Suite 202, Los Angeles, CA 90047 | 2019-06-07 |
| 1598264053 | Dignity Health | Community/Behavioral Health | 1852 W Imperial Hwy, Los Angeles, CA 90047 | 2018-02-09 |
| 1750805222 | Brian George Martinez | Counselor | 1448 W 83rd St, Los Angeles, CA 90047 | 2017-07-27 |
| 1295266609 | Maria Amezcua | Rehabilitation Practitioner | 108 W Victoria Street, Gardena, CA 90047 | 2017-03-27 |
| 1265861140 | Ameika Porter | Counselor | 1529 West 82nd Street, Los Angeles, CA 90047 | 2013-11-01 |
| 1053747519 | Maria D Macias | Counselor | 11601 S. Western Avenue, Los Angeles, CA 90047 | 2013-09-16 |
| 1366704132 | Evelyn Carolina Hernandez | Family Medicine | 1555 West 110th Street, Los Angeles, CA 90047 | 2012-06-08 |
| 1003057142 | Sandra Patricia Trim | Licensed Vocational Nurse | 2048 W 69 St, Los Angeles, CA 90047 | 2009-03-19 |
| 1194962001 | Estuardo Ardon | Counselor | 11603 S. Western Ave., Los Angeles, CA 90047 | 2009-01-14 |
| 1174788400 | Frenda Brigette Williams | Dentist | 2015 W 81st St, Los Angeles, CA 90047 | 2008-07-25 |
| Find all providers in zip 90047 | ||||
| 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 |
| 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 |
| 1992243380 | Vista Del Mar Child and Family Svc. | Residential Treatment Facility, Emotionally Disturbed Children | 3200 Motor Ave, Los Angeles, CA 90034-3710 | 2017-02-06 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90047 |
Please comment or provide details below to improve the information on DELIANN-LUCILE CORPORATION.
| 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.