Provider Demographics
NPI:1093010191
Name:OPERATION SAFEHOUSE
Entity Type:Organization
Organization Name:OPERATION SAFEHOUSE
Other - Org Name:SAFEHOUSE OF THE DESERT
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCADARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-351-4418
Mailing Address - Street 1:9685 HAYES ST
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92503-3660
Mailing Address - Country:US
Mailing Address - Phone:951-351-4418
Mailing Address - Fax:951-351-4265
Practice Address - Street 1:72710 E LYNN ST
Practice Address - Street 2:
Practice Address - City:THOUSAND PALMS
Practice Address - State:CA
Practice Address - Zip Code:92276-3312
Practice Address - Country:US
Practice Address - Phone:760-343-3211
Practice Address - Fax:951-351-4265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-20
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health