Healthcare Provider Details
I. General information
NPI: 1598921579
Provider Name (Legal Business Name): DOOR TO HOPE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/30/2008
Last Update Date: 09/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1929 OXFORD CT
SALINAS CA
93906-2184
US
IV. Provider business mailing address
130 W GABILAN ST
SALINAS CA
93901-2762
US
V. Phone/Fax
- Phone: 831-771-8555
- Fax: 831-758-5127
- Phone: 831-758-0181
- Fax: 831-758-5127
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 320800000X |
| Taxonomy | Mental Illness Community Based Residential Treatment Facility |
| License Number | 275202098 |
| License Number State | CA |
VIII. Authorized Official
Name: MRS.
CHRIS
SHANNON
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 831-758-0181