Provider Demographics
NPI:1134951643
Name:ORANGE GROVE FOUNDATION
Entity type:Organization
Organization Name:ORANGE GROVE FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SANTIAGO
Authorized Official - Middle Name:
Authorized Official - Last Name:NARANJO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-341-3117
Mailing Address - Street 1:PO BOX 65787
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98464-0019
Mailing Address - Country:US
Mailing Address - Phone:425-341-3117
Mailing Address - Fax:
Practice Address - Street 1:1281 S JACKSON AVE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98465-1316
Practice Address - Country:US
Practice Address - Phone:425-341-3117
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-14
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0800XAmbulatory Health Care FacilitiesClinic/CenterRecovery Care
No177F00000XOther Service ProvidersLodging
No251B00000XAgenciesCase Management