Healthcare Provider Details
I. General information
NPI: 1689798985
Provider Name (Legal Business Name): VOLUNTEERS OF AMERICA SOUTHWEST CALIFORNIA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/19/2007
Last Update Date: 03/15/2024
Certification Date: 03/15/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3530 CAMINO DEL RIO N SUITE 300
SAN DIEGO CA
92108-1743
US
IV. Provider business mailing address
3530 CAMINO DEL RIO N SUITE 300
SAN DIEGO CA
92108-1743
US
V. Phone/Fax
- Phone: 619-282-8211
- Fax:
- Phone: 619-282-8211
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251V00000X |
| Taxonomy | Voluntary or Charitable Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251B00000X |
| Taxonomy | Case Management Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251K00000X |
| Taxonomy | Public Health or Welfare Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
MARIE
MCKENZIE
Title or Position: EXECUTIVE VICE PRESIDENT/COO
Credential:
Phone: 619-228-2057