Healthcare Provider Details

I. General information

NPI: 1700549953
Provider Name (Legal Business Name): JAMES PENNY HOUSE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2021
Last Update Date: 10/06/2023
Certification Date: 10/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6428 EASTER LILY CT
BAKERSFIELD CA
93313-6008
US

IV. Provider business mailing address

6428 EASTER LILY CT
BAKERSFIELD CA
93313-6008
US

V. Phone/Fax

Practice location:
  • Phone: 661-832-8407
  • Fax:
Mailing address:
  • Phone: 661-832-8407
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. ROBERT CARTER
Title or Position: DIRECTOR
Credential: MS. CJ
Phone: 661-832-8402