Provider Demographics
NPI: | 1073352159 |
---|---|
Name: | HABITAT FOR HUMANITY GOLDEN EMPIRE |
Entity type: | Organization |
Organization Name: | HABITAT FOR HUMANITY GOLDEN EMPIRE |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | ADMINISTRATIVE ASSISTANT |
Authorized Official - Prefix: | MS |
Authorized Official - First Name: | CLAUDIA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | TALAMANTES |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 661-861-8449 |
Mailing Address - Street 1: | 1500 E 19TH ST |
Mailing Address - Street 2: | |
Mailing Address - City: | BAKERSFIELD |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 93305-5406 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 661-861-8449 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 1500 E 19TH ST |
Practice Address - Street 2: | |
Practice Address - City: | BAKERSFIELD |
Practice Address - State: | CA |
Practice Address - Zip Code: | 93305-5406 |
Practice Address - Country: | US |
Practice Address - Phone: | 661-861-8449 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | HABITAT FOR HUMANITY INTERNATIONAL |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2024-05-20 |
Last Update Date: | 2024-05-20 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 171WH0202X | Other Service Providers | Contractor | Home Modifications | Group - Single Specialty |