Healthcare Provider Details

I. General information

NPI: 1760399216
Provider Name (Legal Business Name): PUENTE HOUSE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

444 W BADILLO ST
COVINA CA
91723-1829
US

IV. Provider business mailing address

444 W BADILLO ST
COVINA CA
91723-1829
US

V. Phone/Fax

Practice location:
  • Phone: 626-437-4308
  • Fax:
Mailing address:
  • Phone: 626-437-4308
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code177F00000X
TaxonomyLodging Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. KARL MORIS
Title or Position: ADMINISTRATOR
Credential:
Phone: 626-437-4308