Provider Demographics
NPI:1629132329
Name:ORANGE COUNTY HALFWAY HOUSE, INC.
Entity Type:Organization
Organization Name:ORANGE COUNTY HALFWAY HOUSE, INC.
Other - Org Name:ORANGE COUNTY YOUTH & FAMILY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SOO
Authorized Official - Middle Name:E
Authorized Official - Last Name:KANG
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:714-543-8468
Mailing Address - Street 1:1415 E 17TH ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-8525
Mailing Address - Country:US
Mailing Address - Phone:714-543-8468
Mailing Address - Fax:714-543-1064
Practice Address - Street 1:12702 JOSEPHINE ST
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92841-4668
Practice Address - Country:US
Practice Address - Phone:714-636-8222
Practice Address - Fax:714-636-0831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA300160AN324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility