Provider Demographics
NPI:1508166612
Name:THE SALVATION ARMY TORRANCE CORPS
Entity Type:Organization
Organization Name:THE SALVATION ARMY TORRANCE CORPS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MAJOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JULIO
Authorized Official - Middle Name:
Authorized Official - Last Name:VASQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-370-4515
Mailing Address - Street 1:4223 EMERALD ST.
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-3093
Mailing Address - Country:US
Mailing Address - Phone:310-370-4515
Mailing Address - Fax:310-370-8835
Practice Address - Street 1:4223 EMERALD ST
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-3001
Practice Address - Country:US
Practice Address - Phone:310-370-4515
Practice Address - Fax:310-370-8835
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-25
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA191605024261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care