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WEST COVINA FOSTER FAMILY AGENCY NPI 1306394879


NPI Information

NPI: 1306394879
Provider Name: WEST COVINA FOSTER FAMILY AGENCY

Doing Business As: SUNRISE HORIZON

Classification: Residential Treatment Facility, Emotionally Disturbed Children - 322D00000X
Entity Type: Organization
Address:
4041 CARROLL COURT
CHINO, CA
ZIP 91710
Phone: (909) 591-2589
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WEST COVINA FOSTER FAMILY AGENCY is a residential treatment facility emotionally disturbed children in Chino, CA. The provider is a residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently. WEST COVINA FOSTER FAMILY AGENCY NPI is 1306394879. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Sunrise Horizon.

The provider's business location address is:

4041 CARROLL COURT
CHINO, CA
ZIP 91710-139
Phone: (909) 591-2589
Fax: (909) 364-2311

The provider's authorized official is Sukhwinder Kaur Singh .
The authorized official title is Chief Executive Officer and has the following contact phone number (626) 814-9085.

The enumeration date for this NPI number is 9/14/2016 and was last updated on 9/22/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103K00000XBehavior AnalystNo
2163WP0807XRegistered NursePsychiatric/Mental Health, Child & AdolescentNo
3171M00000XCase Manager/Care CoordinatorNo
4320800000XCommunity Based Residential Treatment Facility, Mental IllnessNo
5323P00000XPsychiatric Residential Treatment FacilityNo
6322D00000XResidential Treatment Facility, Emotionally Disturbed ChildrenYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1197804217MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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