Provider Demographics
NPI:1407160500
Name:OTHERS INTERNATIONAL, INC.
Entity Type:Organization
Organization Name:OTHERS INTERNATIONAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:HUNT
Authorized Official - Last Name:WIGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-649-7261
Mailing Address - Street 1:11171 OAKWOOD DR
Mailing Address - Street 2:K406
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-4802
Mailing Address - Country:US
Mailing Address - Phone:909-649-7261
Mailing Address - Fax:909-796-2537
Practice Address - Street 1:320 N E ST
Practice Address - Street 2:107
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92401-1540
Practice Address - Country:US
Practice Address - Phone:909-649-7261
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-30
Last Update Date:2010-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS20457101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty