Healthcare Provider Details

I. General information

NPI: 1407785348
Provider Name (Legal Business Name): HOSANNA CHILDREN GROUP HOME INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30522 THE VINTAGE DR
HOMELAND CA
92548-3264
US

IV. Provider business mailing address

6677 SAND DUNES ST
EASTVALE CA
92880-3745
US

V. Phone/Fax

Practice location:
  • Phone: 951-496-9967
  • Fax:
Mailing address:
  • Phone: 951-496-9967
  • 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: MS. DELOIS ESCOTT
Title or Position: ADMINISTRATOR
Credential:
Phone: 951-496-9967