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General NPI Number Information
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NPI Number | 1932767381
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Entity Type | Organization
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Legal Business Name | INTERFAITH COMMUNITY SERVICES
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Dates
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Enumeration Date | 05/31/2019
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Last Update Date | 05/31/2019
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Provider Practice Location Address
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Address Line | 250 N ASH ST
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City | ESCONDIDO
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State | CA
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Zip | 92027-3026
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Country | US
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Telephone | 760-546-8870
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Fax |
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Provider Business Mailing Address
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Address Line | 1820 S ESCONDIDO BLVD STE 100
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City | ESCONDIDO
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State | CA
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Zip | 92025-6535
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Country | US
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Telephone | 760-546-8870
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Fax |
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Authorized Official
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Title or Position | PROGRAM MANAGER
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Name | MR. ROBERT L CHURCH
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Credential | CADC
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Telephone | 760-546-8870
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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