Healthcare Provider Details

I. General information

NPI: 1679071070
Provider Name (Legal Business Name): ZUHA HOMES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2018
Last Update Date: 01/31/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2758 SAN DIMAS CANYON RD
LA VERNE CA
91750-4757
US

IV. Provider business mailing address

6133 JADEITE AVE
RANCHO CUCAMONGA CA
91737-3660
US

V. Phone/Fax

Practice location:
  • Phone: 909-394-9777
  • Fax: 909-506-4446
Mailing address:
  • Phone: 909-919-3497
  • Fax: 909-244-9414

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code315P00000X
TaxonomyIntellectual Disabilities Intermediate Care Facility
License Number960000689
License Number StateCA

VIII. Authorized Official

Name: MR. AHMAD UMAR
Title or Position: CEO/PRESIDENT
Credential:
Phone: 909-919-3497