Provider Demographics
NPI:1700200292
Name:TOM'S HOLDING COMPANY
Entity Type:Organization
Organization Name:TOM'S HOLDING COMPANY
Other - Org Name:WONDERLAND EPA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:D
Authorized Official - Last Name:SHOHET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-899-9115
Mailing Address - Street 1:8033 W SUNSET BLVD STE 3400
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90046-2401
Mailing Address - Country:US
Mailing Address - Phone:323-899-9115
Mailing Address - Fax:323-870-8200
Practice Address - Street 1:8945 WONDERLAND AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90046-1853
Practice Address - Country:US
Practice Address - Phone:323-899-9115
Practice Address - Fax:323-870-8200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-05
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility