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10 ACRE RANCH NPI 1053724716


NPI Information

NPI: 1053724716
Provider Name: 10 ACRE RANCH
Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization

CLIA Number: 05D2289987

Address:
8605 JANET AVE
RIVERSIDE, CA
ZIP 92503
Phone: (877) 228-4679
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10 ACRE RANCH is a substance abuse rehabilitation facility in Riverside, CA. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. 10 ACRE RANCH NPI is 1053724716. The provider is registered as an organization entity type.

The provider's business location address is:

8605 JANET AVE
RIVERSIDE, CA
ZIP 92503-212
Phone: (877) 228-4679
Fax: (951) 602-6655

The provider's authorized official is Ismail Jadallah .
The authorized official title is Administrator and has the following contact phone number (714) 833-4826.

The CLIA number assigned to this NPI record is 05D2289987 - other - inpatient substance abuse with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/10/2014 and was last updated on 7/21/2022.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1324500000XSubstance Abuse Rehabilitation FacilityCALIFORNIAYes

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

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.