Provider Demographics
NPI:1629406442
Name:WOMANHAVEN, INC.
Entity Type:Organization
Organization Name:WOMANHAVEN, INC.
Other - Org Name:CENTER FOR FAMILY SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR FOR ADMINISTRATIVE SERVICE
Authorized Official - Prefix:
Authorized Official - First Name:YEREIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SOTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-337-4014
Mailing Address - Street 1:P.O. BOX 2219
Mailing Address - Street 2:
Mailing Address - City:EL CENTRO
Mailing Address - State:CA
Mailing Address - Zip Code:92243-2219
Mailing Address - Country:US
Mailing Address - Phone:760-353-6922
Mailing Address - Fax:760-353-6922
Practice Address - Street 1:510 W MAIN ST STE 104
Practice Address - Street 2:
Practice Address - City:EL CENTRO
Practice Address - State:CA
Practice Address - Zip Code:92243-2900
Practice Address - Country:US
Practice Address - Phone:760-337-3915
Practice Address - Fax:760-353-8372
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-15
Last Update Date:2018-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable
No251B00000XAgenciesCase Management
No251X00000XAgenciesSupports Brokerage
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No347E00000XTransportation ServicesTransportation Broker