Provider Demographics
NPI:1811193345
Name:KINSHIP CENTER
Entity Type:Organization
Organization Name:KINSHIP CENTER
Other - Org Name:CYS KINSHIP CENTER WRAPAROUND
Other - Org Type:Other Name
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPHINE
Authorized Official - Middle Name:AYE
Authorized Official - Last Name:ROEMHILD
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:714-881-8601
Mailing Address - Street 1:18302 IRVINE BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-3437
Mailing Address - Country:US
Mailing Address - Phone:714-881-8600
Mailing Address - Fax:714-432-8261
Practice Address - Street 1:18302 IRVINE BLVD STE 300
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-3437
Practice Address - Country:US
Practice Address - Phone:714-881-8600
Practice Address - Fax:714-432-8261
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-22
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health