Provider Demographics
NPI:1659111987
Name:WAYMAKERS
Entity type:Organization
Organization Name:WAYMAKERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF PROGRAM OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:HETHER
Authorized Official - Middle Name:L
Authorized Official - Last Name:LOMBARDO-BENJAMIN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:949-250-0488
Mailing Address - Street 1:440 EXCHANGE STE 250
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92602-1376
Mailing Address - Country:US
Mailing Address - Phone:949-250-0488
Mailing Address - Fax:714-540-1908
Practice Address - Street 1:440 EXCHANGE STE 250
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92602-1376
Practice Address - Country:US
Practice Address - Phone:949-250-0488
Practice Address - Fax:714-540-1908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-24
Last Update Date:2024-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management