Provider Demographics
NPI:1598492639
Name:THE SALVATION ARMY A CALIFORNIA CORP
Entity type:Organization
Organization Name:THE SALVATION ARMY A CALIFORNIA CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ST PHH INTAKE/BILLING
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:D
Authorized Official - Last Name:LINDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-522-3209
Mailing Address - Street 1:PO BOX 1663
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95353-1663
Mailing Address - Country:US
Mailing Address - Phone:209-522-3209
Mailing Address - Fax:209-522-2033
Practice Address - Street 1:310 10TH STREET
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95351
Practice Address - Country:US
Practice Address - Phone:209-522-3209
Practice Address - Fax:209-522-2033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-08
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care