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PEEBLES FAMILY CARE HOME NPI 1578749149


NPI Information

NPI: 1578749149
Provider Name: PEEBLES FAMILY CARE HOME

Doing Business As: PALS ASSISTED LIVING SERVICES INC

Classification: Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320600000X
Entity Type: Organization
Address:
404 NORTH BROADWAY AVE
STOCKTON, CA
ZIP 95205
Phone: (209) 464-3024
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PEEBLES FAMILY CARE HOME is a residential treatment facility, intellectual and/or developmental disabilities in Stockton, CA. The provider is a residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently. PEEBLES FAMILY CARE HOME NPI is 1578749149. The provider is registered as an organization entity type.
The provider Is Doing Business As Pals Assisted Living Services Inc.

The provider's business location address is:

404 NORTH BROADWAY AVE
STOCKTON, CA
ZIP 95205
Phone: (209) 464-3024
Fax: (209) 944-5659

The provider's authorized official is Nawana Miesa Gray .
The authorized official title is Administrator Ceo and has the following contact phone number (209) 298-0849.

The enumeration date for this NPI number is 1/14/2008 and was last updated on 1/14/2008.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1320600000XResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesCALIFORNIAYes

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: 5/5/2024

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