Provider Demographics
NPI:1043623143
Name:ASSISTANCE LEAGUE OF ORANGE
Entity Type:Organization
Organization Name:ASSISTANCE LEAGUE OF ORANGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTAL CHAIRMAN
Authorized Official - Prefix:
Authorized Official - First Name:THERESE
Authorized Official - Middle Name:
Authorized Official - Last Name:HANCOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-272-3011
Mailing Address - Street 1:124 S ORANGE ST
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92866-1424
Mailing Address - Country:US
Mailing Address - Phone:714-997-5350
Mailing Address - Fax:
Practice Address - Street 1:126 S ORANGE ST
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92866-1424
Practice Address - Country:US
Practice Address - Phone:714-997-5350
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-05
Last Update Date:2014-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable