Provider Demographics
NPI:1245740810
Name:IU-MIEN COMMUNITY SERVICES
Entity Type:Organization
Organization Name:IU-MIEN COMMUNITY SERVICES
Other - Org Name:UNITED IU-MIEN COMMUNITY, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:EXCUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KAO
Authorized Official - Middle Name:C
Authorized Official - Last Name:THUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-383-3083
Mailing Address - Street 1:PO BOX 245693
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95824-5693
Mailing Address - Country:US
Mailing Address - Phone:916-383-3083
Mailing Address - Fax:
Practice Address - Street 1:5625 STOCKTON BLVD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95824-1611
Practice Address - Country:US
Practice Address - Phone:916-383-3083
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-09
Last Update Date:2017-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes405300000XOther Service ProvidersPrevention ProfessionalGroup - Single Specialty