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General NPI Number Information
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NPI Number | 1740918846
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Entity Type | Organization
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Legal Business Name | THOMAS HOUSE TEMPORARY SHELTER
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Dates
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Enumeration Date | 08/08/2022
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Last Update Date | 08/19/2022
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Provider Practice Location Address
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Address Line | 12601 MORNINGSIDE AVE APT 6
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City | GARDEN GROVE
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State | CA
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Zip | 92843-4517
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Country | US
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Telephone | 714-554-0357
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2737
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City | GARDEN GROVE
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State | CA
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Zip | 92842-2737
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Country | US
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Telephone | 714-554-0357
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. SHAKOYA DENISHA GREEN LONG
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Credential | ACSW
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Telephone | 951-238-0920
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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