Provider Demographics
NPI:1225874977
Name:YELLOWSTONE WOMEN'S FIRST STEP HOUSE, INC.
Entity type:Organization
Organization Name:YELLOWSTONE WOMEN'S FIRST STEP HOUSE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CASEY
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-678-3214
Mailing Address - Street 1:154 E BAY ST
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92627-2147
Mailing Address - Country:US
Mailing Address - Phone:888-418-4188
Mailing Address - Fax:949-209-0369
Practice Address - Street 1:2319 WHITESANDS DR APT 1
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-2855
Practice Address - Country:US
Practice Address - Phone:888-418-4188
Practice Address - Fax:949-209-0369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-02
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility