Provider Demographics
NPI:1992498521
Name:TAHOE COALITION FOR THE HOMELESS
Entity type:Organization
Organization Name:TAHOE COALITION FOR THE HOMELESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF HOUSING
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:PETERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-719-2553
Mailing Address - Street 1:PO BOX 13514
Mailing Address - Street 2:
Mailing Address - City:SOUTH LAKE TAHOE
Mailing Address - State:CA
Mailing Address - Zip Code:96151-3514
Mailing Address - Country:US
Mailing Address - Phone:530-600-2822
Mailing Address - Fax:
Practice Address - Street 1:1137 EMERALD BAY RD OFC
Practice Address - Street 2:
Practice Address - City:SOUTH LAKE TAHOE
Practice Address - State:CA
Practice Address - Zip Code:96150-6362
Practice Address - Country:US
Practice Address - Phone:530-600-2822
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-30
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251X00000XAgenciesSupports Brokerage
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty