Provider Demographics
NPI:1427774736
Name:SALVATION NEIGHBORHOOD DEVELOPMENT CORPORATION
Entity type:Organization
Organization Name:SALVATION NEIGHBORHOOD DEVELOPMENT CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AMANDO
Authorized Official - Middle Name:O
Authorized Official - Last Name:SILVA
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:224-558-9705
Mailing Address - Street 1:692 E PHILLIPS BLVD
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91766-4549
Mailing Address - Country:US
Mailing Address - Phone:224-558-9705
Mailing Address - Fax:
Practice Address - Street 1:692 E PHILLIPS BLVD
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91766-4549
Practice Address - Country:US
Practice Address - Phone:224-558-9705
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-18
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service