Provider Demographics
NPI:1881904050
Name:OTHERS INTERNATIONAL, INC.
Entity type:Organization
Organization Name:OTHERS INTERNATIONAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:HUNT
Authorized Official - Last Name:WIGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-649-7261
Mailing Address - Street 1:101 W MISSION BLVD
Mailing Address - Street 2:110-141
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91766-1711
Mailing Address - Country:US
Mailing Address - Phone:909-649-7261
Mailing Address - Fax:909-796-2537
Practice Address - Street 1:375 S MAIN ST
Practice Address - Street 2:226
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91766-1624
Practice Address - Country:US
Practice Address - Phone:909-649-7261
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-20
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS265901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty