Provider Demographics
NPI:1760266472
Name:THE SALVATION ARMY - A CALIFORNIA CORPORATION
Entity Type:Organization
Organization Name:THE SALVATION ARMY - A CALIFORNIA CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HURST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-210-6037
Mailing Address - Street 1:10200 PIONEER RD.
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92782
Mailing Address - Country:US
Mailing Address - Phone:714-210-6037
Mailing Address - Fax:
Practice Address - Street 1:1455 S. SALVATION PLACE
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92805
Practice Address - Country:US
Practice Address - Phone:714-210-6037
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE SALVATION ARMY - A CALIFORNIA CORP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-08-23
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health