Ettie Lee Youth and Family Services

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

#50219 Issued in CA

Legal business name

ETTIE LEE YOUTH AND FAMILY SERVICES

Practice address

12345 Chandler Blvd
North Hollywood, CA 91607-2079

Phone

(818) 760-0665

Fax

(818) 760-0157

NPI assigned

Mar 19, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Leane Catherine Shilling, M.S., IMF

Title

Therapeutic Social Worker

Phone

(818) 915-5497

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214352000000",
    "number": "1104941442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10621 VALLEY SPRING LN",
            "address_2": "#305",
            "city": "TOLUCA LAKE",
            "state": "CA",
            "postal_code": "916023200",
            "telephone_number": "818-760-9548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12345 CHANDLER BLVD",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916072079",
            "telephone_number": "818-760-0665",
            "fax_number": "818-760-0157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETTIE LEE YOUTH AND FAMILY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2008-06-25",
        "status": "A",
        "authorized_official_last_name": "SHILLING",
        "authorized_official_first_name": "LEANE",
        "authorized_official_middle_name": "CATHERINE",
        "authorized_official_title_or_position": "THERAPEUTIC SOCIAL WORKER",
        "authorized_official_telephone_number": "818-915-5497",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.S., IMF"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "CA",
            "license": "#50219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.