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TURQUOISE DIVISION NPI 1003068479


NPI Information

NPI: 1003068479
Provider Name: TURQUOISE DIVISION
Classification: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320900000X
Entity Type: Organization
Address:
9140 MONTE VISTA AVE
MONTCLAIR, CA
ZIP 91763
Phone: (909) 624-2774
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TURQUOISE DIVISION is a community based residential treatment facility, intellectual and/or developmental disabilities in Montclair, CA. The provider is a home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. TURQUOISE DIVISION NPI is 1003068479. The provider is registered as an organization entity type.

The provider's business location address is:

9140 MONTE VISTA AVE
MONTCLAIR, CA
ZIP 91763-723
Phone: (909) 624-2774
Fax: (909) 624-6014

The provider's authorized official is Parluhutan Wahab Siregar .
The authorized official title is Qmrp/administrator and has the following contact phone number (909) 624-2774.

The enumeration date for this NPI number is 10/16/2008 and was last updated on 10/16/2008.


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
1320900000XCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities240000825CALIFORNIAYes

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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