Provider Demographics
NPI:1518101336
Name:CHAPMAN HOUSE, INC
Entity Type:Organization
Organization Name:CHAPMAN HOUSE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:TIM
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MSCD, CSAC
Authorized Official - Phone:714-288-9779
Mailing Address - Street 1:1412 E CHAPMAN AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92866-2229
Mailing Address - Country:US
Mailing Address - Phone:714-288-9779
Mailing Address - Fax:
Practice Address - Street 1:14511 CARFAX DR
Practice Address - Street 2:14512 CARFAX DR.
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-6243
Practice Address - Country:US
Practice Address - Phone:714-288-9779
Practice Address - Fax:714-288-6130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-23
Last Update Date:2009-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility