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General NPI Number Information
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NPI Number | 1194972653
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Entity Type | Organization
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Legal Business Name | WOMEN ON THE WAY RECOVERY CENTER
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Dates
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Enumeration Date | 08/26/2008
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Last Update Date | 08/26/2008
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Provider Practice Location Address
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Address Line | 20424 HAVILAND AVE
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City | HAYWARD
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State | CA
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Zip | 94541-1967
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Country | US
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Telephone | 510-276-3661
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Fax | 510-278-7933
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Provider Business Mailing Address
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Address Line | 20424 HAVILAND AVE
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City | HAYWARD
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State | CA
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Zip | 94541-1967
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Country | US
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Telephone | 510-276-3661
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Fax | 510-278-7933
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | MRS. BARBARA QUINTERO
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Credential | RAS
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Telephone | 510-276-3667
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | 010072AN
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License Number State | CA
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