Provider Demographics
NPI:1811237928
Name:THE LGBT COMMUNITY CENTER
Entity type:Organization
Organization Name:THE LGBT COMMUNITY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DATABASE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AUTUMN
Authorized Official - Middle Name:
Authorized Official - Last Name:RASHAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-692-2077
Mailing Address - Street 1:3909 CENTRE ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-3410
Mailing Address - Country:US
Mailing Address - Phone:619-692-2077
Mailing Address - Fax:619-718-6447
Practice Address - Street 1:3909 CENTRE ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-3410
Practice Address - Country:US
Practice Address - Phone:619-692-2077
Practice Address - Fax:619-718-6447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-26
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health