Healthcare Provider Details
I. General information
NPI: 1942417944
Provider Name (Legal Business Name): THE SALVATION ARMY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/17/2007
Last Update Date: 10/06/2023
Certification Date: 10/06/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
401 DEL NORTE AVE
YUBA CITY CA
95991-4113
US
IV. Provider business mailing address
401 DEL NORTE AVE
YUBA CITY CA
95991-4113
US
V. Phone/Fax
- Phone: 530-216-4530
- Fax: 530-671-7213
- Phone: 530-216-4530
- Fax: 530-671-7213
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171W00000X |
| Taxonomy | Contractor |
| License Number | 5800005AN |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251C00000X |
| Taxonomy | Developmentally Disabled Services Day Training Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251X00000X |
| Taxonomy | Supports Brokerage Agency |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332U00000X |
| Taxonomy | Home Delivered Meals |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JULIUS
MURPHY
Title or Position: CORPS OFFICER
Credential:
Phone: 530-216-4533