Healthcare Provider Details

I. General information

NPI: 1699848309
Provider Name (Legal Business Name): ZARAHEMLA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2816 MARCO CT
LA VERNE CA
91750-4661
US

IV. Provider business mailing address

PO BOX 1542
UPLAND CA
91785-1542
US

V. Phone/Fax

Practice location:
  • Phone: 626-701-4635
  • Fax: 909-506-4403
Mailing address:
  • Phone: 909-467-2560
  • Fax: 909-506-4403

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number StateCA

VIII. Authorized Official

Name: MRS. JILL N CRISCIONE
Title or Position: SECRETARY
Credential:
Phone: 909-467-2560