=====================================================
General NPI Number Information
=====================================================
NPI Number | 1629335096
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TURNING POINT COMMUNITY PROGRAMS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/23/2012
-----------------------------------------------------
Last Update Date | 04/23/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 627 W MAIN ST
-----------------------------------------------------
City | MERCED
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95340-4717
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 209-723-6804
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 627 W MAIN ST
-----------------------------------------------------
City | MERCED
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95340-4717
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ASSISTANT PROGRAM DIRECTOR
-----------------------------------------------------
Name | MS. DONNA DENNERLEIN
-----------------------------------------------------
Credential | MSW
-----------------------------------------------------
Telephone | 209-723-6804
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 302F00000X
-----------------------------------------------------
Taxonomy Name | Exclusive Provider Organization
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------