Provider Demographics
NPI:1912699752
Name:INTERFAITH COMMUNITY SERVICES
Entity Type:Organization
Organization Name:INTERFAITH COMMUNITY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMPLIANCE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:VARNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-546-8605
Mailing Address - Street 1:550 W WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-1643
Mailing Address - Country:US
Mailing Address - Phone:760-480-6380
Mailing Address - Fax:
Practice Address - Street 1:555 N CENTRE CITY PKWY
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-2517
Practice Address - Country:US
Practice Address - Phone:760-489-6380
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
No251B00000XAgenciesCase Management