Provider Demographics
NPI:1932798170
Name:COMMUNITY HOMELESS SOLUTIONS
Entity Type:Organization
Organization Name:COMMUNITY HOMELESS SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSEN
Authorized Official - Suffix:
Authorized Official - Credentials:MBD, MDIV
Authorized Official - Phone:831-384-3388
Mailing Address - Street 1:PO BOX 1340
Mailing Address - Street 2:
Mailing Address - City:MARINA
Mailing Address - State:CA
Mailing Address - Zip Code:93933-1340
Mailing Address - Country:US
Mailing Address - Phone:831-384-3388
Mailing Address - Fax:831-384-1308
Practice Address - Street 1:780 HAMILTON AVE
Practice Address - Street 2:
Practice Address - City:SEASIDE
Practice Address - State:CA
Practice Address - Zip Code:93955-4818
Practice Address - Country:US
Practice Address - Phone:831-747-2900
Practice Address - Fax:844-315-2241
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-12
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes177F00000XOther Service ProvidersLodging