Provider Demographics
NPI:1093940561
Name:DEAF COMMUNITY SERVICES OF SAN DIEGO INC
Entity Type:Organization
Organization Name:DEAF COMMUNITY SERVICES OF SAN DIEGO INC
Other - Org Name:DEAF COMMUNITY SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MONIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:BALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-376-1697
Mailing Address - Street 1:1240 E PLAZA BLVD STE 604
Mailing Address - Street 2:
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950-3664
Mailing Address - Country:US
Mailing Address - Phone:619-376-1697
Mailing Address - Fax:
Practice Address - Street 1:2240 CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-6412
Practice Address - Country:US
Practice Address - Phone:619-376-1697
Practice Address - Fax:619-398-2437
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-27
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health