Provider Demographics
NPI:1578680534
Name:VOLUNTEERS OF AMERICA SOUTHWEST CALIFORNIA
Entity Type:Organization
Organization Name:VOLUNTEERS OF AMERICA SOUTHWEST CALIFORNIA
Other - Org Name:TROY CENTER FOR SUPPORTIVE LIVING
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT/COO
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKENZIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-228-2057
Mailing Address - Street 1:3530 CAMINO DEL RIO N STE 300
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-1746
Mailing Address - Country:US
Mailing Address - Phone:619-228-2057
Mailing Address - Fax:
Practice Address - Street 1:8627 TROY ST
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91977-2535
Practice Address - Country:US
Practice Address - Phone:619-465-8792
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness