HABILITATIVE HOMES RESIDENTIAL CARE FACILITY NPI 1891167912

NPI Information

NPI: 1891167912
Provider Name: HABILITATIVE HOMES RESIDENTIAL CARE FACILITY
Classification: Assisted Living Facility - 310400000X
Entity Type: Organization
Address:
11775 WALNUT RD
LAKESIDE, CA
ZIP 92040
Phone: (619) 270-4484
Get Directions

HABILITATIVE HOMES RESIDENTIAL CARE FACILITY is an assisted living facility in Lakeside, CA. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. HABILITATIVE HOMES RESIDENTIAL CARE FACILITY NPI is 1891167912. The provider is registered as an organization entity type.

The provider's business location address is:

11775 WALNUT RD
LAKESIDE, CA
ZIP 92040-624
Phone: (619) 270-4484

The provider's authorized official is David Clarence Larson .
The authorized official title is Licenee/owner/administrator and has the following contact phone number (619) 456-3742.

The enumeration date for this NPI number is 10/28/2015 and was last updated on 3/16/2016.

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
1	3104A0630X	Assisted Living Facility	Assisted Living, Behavioral Disturbances	374603669	CALIFORNIA	No
2	311ZA0620X	Custodial Care Facility	Adult Care Home	374603669	CALIFORNIA	No
3	320800000X	Community Based Residential Treatment Facility, Mental Illness		374603669	CALIFORNIA	No
4	310400000X	Assisted Living Facility		374603669	CALIFORNIA	Yes

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

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »