Provider Demographics
NPI:1518381821
Name:TEHACHAPI WELLNESS CENTER
Entity Type:Organization
Organization Name:TEHACHAPI WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RENA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHUMWAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-822-8979
Mailing Address - Street 1:21030 MISSION ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:TEHACHAPI
Mailing Address - State:CA
Mailing Address - Zip Code:93561-6769
Mailing Address - Country:US
Mailing Address - Phone:661-822-8979
Mailing Address - Fax:661-822-5729
Practice Address - Street 1:21030 MISSION ST
Practice Address - Street 2:SUITE A
Practice Address - City:TEHACHAPI
Practice Address - State:CA
Practice Address - Zip Code:93561-6769
Practice Address - Country:US
Practice Address - Phone:661-822-8979
Practice Address - Fax:661-822-5729
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-06
Last Update Date:2014-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty