Healthcare Provider Details

I. General information

NPI: 1477037299
Provider Name (Legal Business Name): CALIFORNIA HOME FOR THE ADULT DEAF
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2018
Last Update Date: 09/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3615 CROWELL AVE
RIVERSIDE CA
92504-3549
US

IV. Provider business mailing address

3615 CROWELL AVE
RIVERSIDE CA
92504-3549
US

V. Phone/Fax

Practice location:
  • Phone: 562-206-0185
  • Fax:
Mailing address:
  • Phone: 562-206-0185
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: SCOTT K HOSTETLER
Title or Position: CEO
Credential:
Phone: 562-206-0185