Provider Demographics
NPI:1841626116
Name:WALKER HOUSE/ WILLIAMS HOUSE I & II
Entity type:Organization
Organization Name:WALKER HOUSE/ WILLIAMS HOUSE I & II
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:MENDOZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-462-6995
Mailing Address - Street 1:1095 WEEKS ST
Mailing Address - Street 2:
Mailing Address - City:EAST PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94303-1341
Mailing Address - Country:US
Mailing Address - Phone:650-462-6999
Mailing Address - Fax:650-462-1055
Practice Address - Street 1:1095 WEEKS ST
Practice Address - Street 2:
Practice Address - City:EAST PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94303-1341
Practice Address - Country:US
Practice Address - Phone:650-462-6999
Practice Address - Fax:650-462-1055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-18
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
410027AN324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA410027ANOtherREHABILITATION SERVICES