Organization Name: | PROVIDENCE COMMUNITY SERVICES |
NPI Number: | 1093134900 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MICHELLE MOLNAR (DIRECTOR OF FINANCE) |
Mailing Address: | 30021 Tomas Suite #300 Rancho Santa Margarita |
State: | CA US |
Postal Code: | 926882128 |
Phone Number: | 5624675577 |
Fax Number: | 5624675553 |
NPI Enumeration Date: | 04/08/2014 |
NPI Last Update Date: | 04/08/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |