Healthcare Provider Details
I. General information
NPI: 1720399009
Provider Name (Legal Business Name): INTERIM, INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/01/2010
Last Update Date: 10/11/2023
Certification Date: 10/11/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
613 BAYONET CIR
MARINA CA
93933-4600
US
IV. Provider business mailing address
604 PEARL ST
MONTEREY CA
93940-3070
US
V. Phone/Fax
- Phone: 831-649-4522
- Fax: 831-647-9136
- Phone: 831-649-4522
- Fax: 831-647-9136
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RHIYAN
ARAFILES
QUITON
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 831-649-4522