Provider Demographics
NPI:1679970826
Name:COMMUNITY HUMAN SERVICES OFF MAIN CLINIC
Entity Type:Organization
Organization Name:COMMUNITY HUMAN SERVICES OFF MAIN CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:
Authorized Official - Last Name:LOISEL
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:831-424-4828
Mailing Address - Street 1:2560 GARDEN RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-5338
Mailing Address - Country:US
Mailing Address - Phone:831-658-2811
Mailing Address - Fax:831-658-3815
Practice Address - Street 1:2560 GARDEN RD
Practice Address - Street 2:SUITE 201
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-5338
Practice Address - Country:US
Practice Address - Phone:831-658-2811
Practice Address - Fax:831-658-3815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-03
Last Update Date:2014-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management