Provider Demographics
NPI:1932324381
Name:INTERIM, INCORPORATED
Entity Type:Organization
Organization Name:INTERIM, INCORPORATED
Other - Org Name:INTERIM MANZANITA HOUSE CRISIS SHORT TERM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RHIYAN
Authorized Official - Middle Name:ARAFILES
Authorized Official - Last Name:QUITON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:831-649-4522
Mailing Address - Street 1:604 PEARL ST
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-3070
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 CASENTINI ST
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93907-2299
Practice Address - Country:US
Practice Address - Phone:831-649-4522
Practice Address - Fax:831-647-9136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA275200797320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA2727Medicaid