Healthcare Provider Details

I. General information

NPI: 1588595367
Provider Name (Legal Business Name): BETTYS HOUSE OF CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

428 BONITO AVE
LONG BEACH CA
90802-1644
US

IV. Provider business mailing address

428 BONITO AVE
LONG BEACH CA
90802-1644
US

V. Phone/Fax

Practice location:
  • Phone: 562-857-4649
  • Fax:
Mailing address:
  • Phone: 562-857-4649
  • Fax:

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 State

VIII. Authorized Official

Name: MRS. AISHA EMAGUNA
Title or Position: EXECUTIVE DIRECTOR/ADMINISTRATOR
Credential:
Phone: 562-857-4648