Healthcare Provider Details

I. General information

NPI: 1871004341
Provider Name (Legal Business Name): FATHER'S HEART- A RANCH FOR CHILDREN INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2017
Last Update Date: 01/27/2021
Certification Date: 01/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

71175 AURORA RD
DESERT HOT SPRINGS CA
92241-7631
US

IV. Provider business mailing address

71175 AURORA RD
DESERT HOT SPRINGS CA
92241-7631
US

V. Phone/Fax

Practice location:
  • Phone: 760-251-8858
  • Fax: 760-329-8889
Mailing address:
  • Phone: 760-251-8858
  • Fax: 760-329-8889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number336406377
License Number StateCA

VIII. Authorized Official

Name: MRS. CHRISTINA LOUISE SALAS TORRES
Title or Position: ADMINISTRATIVE DIRECTOR
Credential:
Phone: 760-251-8858