Provider Demographics
NPI:1174861645
Name:TURRILL TRANSITIONAL ASSISTANCE PROGRAM, INC.
Entity Type:Organization
Organization Name:TURRILL TRANSITIONAL ASSISTANCE PROGRAM, INC.
Other - Org Name:NEXT STEP RECOVERY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:KANAVOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-965-4708
Mailing Address - Street 1:2130 N ARROWHEAD AVE
Mailing Address - Street 2:SUITE 206H
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92405-4029
Mailing Address - Country:US
Mailing Address - Phone:909-475-8600
Mailing Address - Fax:909-475-8669
Practice Address - Street 1:5789 MERITO AVE
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92404-7215
Practice Address - Country:US
Practice Address - Phone:909-886-6678
Practice Address - Fax:909-886-6678
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-17
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA360090AN324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility