Healthcare Provider Details

I. General information

NPI: 1659561314
Provider Name (Legal Business Name): ANGEL VIEW CRIPPLED CHILDRENS FOUNDATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2007
Last Update Date: 07/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13785 VIA REAL
DESERT HOT SPRINGS CA
92240
US

IV. Provider business mailing address

12379 MIRACLE HILL ROAD
DESERT HOT SPRINGS CA
92240-4010
US

V. Phone/Fax

Practice location:
  • Phone: 760-329-8403
  • Fax:
Mailing address:
  • Phone: 760-329-6471
  • Fax: 760-329-9024

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StateCA

VIII. Authorized Official

Name: MR. DAVID C THORNTON
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 760-329-6471