Healthcare Provider Details

I. General information

NPI: 1891000360
Provider Name (Legal Business Name): ROBSAG INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2010
Last Update Date: 08/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

811 E WASHINGTON BLVD
PASADENA CA
91104-5013
US

IV. Provider business mailing address

1760 N FAIR OAKS AVE
PASADENA CA
91103-1617
US

V. Phone/Fax

Practice location:
  • Phone: 626-797-7296
  • Fax:
Mailing address:
  • Phone: 626-797-7296
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number197602925
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code320700000X
TaxonomyPhysical Disabilities Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. MARK DOUGLAS HAMILTON
Title or Position: ADMINISTRATOR
Credential:
Phone: 626-794-4103