MEDICARE: EPISCOPAL COMMUNITY SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251B00000X	Case Management Agency
2	251S00000X	Community/Behavioral Health Agency
3	252Y00000X	Early Intervention Provider Agency

General Provider Information

NPI Number	:	1295852325
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EPISCOPAL COMMUNITY SERVICES

Provider Business Mailing Address
First Line	:	401 MILE OF CARS WAY
Second Line	:	SUITE 350
City	:	NATIONAL CITY
State	:	CA
Zip	:	91950-6610
Country	:	US
Telephone Number	:	619-228-2800
Fax Number	:	619-228-2801

Provider Business Practice Location Address
First Line	:	1424 30TH ST
Second Line	:	SUITE A
City	:	SAN DIEGO
State	:	CA
Zip	:	92154-3421
Country	:	US
Telephone Number	:	619-565-2650
Fax Number	:	619-565-2656

Authorized Official
Title or Position	:	CHIEF OPERATING OFFICER
Name	:	MR. CHRISTOPHER JOSEPH MARICS
Credential	:	MSW
Telephone Number	:	619-228-2800

Provider Enumeration Date	:	03/23/2007
Last Update Date	:	12/15/2016

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