Provider Demographics
NPI:1508095415
Name:DAYLE MCINTOSH CENTER FOR THE DISABLED
Entity Type:Organization
Organization Name:DAYLE MCINTOSH CENTER FOR THE DISABLED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DOLORES
Authorized Official - Middle Name:
Authorized Official - Last Name:KOLLMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-621-3300
Mailing Address - Street 1:13272 GARDEN GROVE BLVD
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92843-2205
Mailing Address - Country:US
Mailing Address - Phone:714-621-3300
Mailing Address - Fax:714-663-2094
Practice Address - Street 1:13272 GARDEN GROVE BLVD
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-2205
Practice Address - Country:US
Practice Address - Phone:714-621-3300
Practice Address - Fax:714-663-2094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-13
Last Update Date:2009-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251X00000XAgenciesSupports Brokerage