Provider Demographics
NPI:1548419807
Name:WESTMINSTER TRC
Entity Type:Organization
Organization Name:WESTMINSTER TRC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:
Authorized Official - Last Name:ERVIN-ASSIGAL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:714-895-1985
Mailing Address - Street 1:206 HOSPITAL CIR
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-3910
Mailing Address - Country:US
Mailing Address - Phone:714-895-1985
Mailing Address - Fax:
Practice Address - Street 1:206 HOSPITAL CIR
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-3910
Practice Address - Country:US
Practice Address - Phone:714-895-1985
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-11
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALVN 34924323P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility