Basic Information
| Provider Information | |||||||||
| NPI: | 1295940013 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | DOOR TO HOPE | ||||||||
| LastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 130 W GABILAN ST | ||||||||
| Address2: | |||||||||
| City: | SALINAS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 939012762 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8317580181 | ||||||||
| FaxNumber: | 8317585127 | ||||||||
| Practice Location | |||||||||
| Address1: | 130 W GABILAN ST | ||||||||
| Address2: | |||||||||
| City: | SALINAS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 939012762 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8317580181 | ||||||||
| FaxNumber: | 8317585127 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/14/2007 | ||||||||
| LastUpdateDate: | 09/11/2015 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | SHANNON | ||||||||
| AuthorizedOfficialFirstName: | CHRIS | ||||||||
| AuthorizedOfficialMiddleName: | A. | ||||||||
| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 8317580181 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | C272702 | CA | Y | Agencies | Community/Behavioral Health |
No ID Information.