| Organization Name: | PROVIDENCE COMMUNITY SERVICES |
| NPI Number: | 1124440714 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHELLE MOLNAR (DIRECTOR OF FINANCE) |
| Mailing Address: | 1230 Rosecrans Ave Suite 300 Manhattan Beach |
| State: | CA US |
| Postal Code: | 902662477 |
| Phone Number: | 5624675577 |
| Fax Number: | 5624675553 |
| NPI Enumeration Date: | 01/15/2014 |
| NPI Last Update Date: | 01/15/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |