Healthcare Provider Details

I. General information

NPI: 1801575535
Provider Name (Legal Business Name): ENCOMPASS HOUSING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2023
Last Update Date: 07/11/2023
Certification Date: 07/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 S HARBOR BLVD STE 100
SANTA ANA CA
92704-6418
US

IV. Provider business mailing address

2900 S HARBOR BLVD STE 100
SANTA ANA CA
92704-6418
US

V. Phone/Fax

Practice location:
  • Phone: 714-791-9148
  • Fax:
Mailing address:
  • Phone: 714-791-9148
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code177F00000X
TaxonomyLodging Provider
License Number
License Number StateNULL
# 4
Primary TaxonomyY
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: DEBY WOLFORD
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 714-791-9148