FERN HOME 1 LLC NPI 1972029486

NPI Information

NPI: 1972029486
Provider Name: FERN HOME 1 LLC

Other Name: FERN HOME 1

Classification: Assisted Living Facility - 310400000X
Entity Type: Organization
Address:
3875 MEGGINSON LN
RIVERSIDE, CA
ZIP 92503
Phone: (310) 997-8204
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FERN HOME 1 LLC is an assisted living facility in Riverside, 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. FERN HOME 1 LLC NPI is 1972029486. The provider is registered as an organization entity type.
The provider Other Name Is Fern Home 1.

The provider's business location address is:

3875 MEGGINSON LN
RIVERSIDE, CA
ZIP 92503-425
Phone: (310) 997-8204

The provider's authorized official is Joi Mae Gubalane .
The authorized official title is Licensee/administrator and has the following contact phone number (310) 997-8204.

The enumeration date for this NPI number is 8/16/2017 and was last updated on 8/16/2017.

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	310400000X	Assisted Living Facility		331800142	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: 11/14/2023

NPI Synchronization or Removal

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