Healthcare Provider Details
I. General information
NPI: 1972325355
Provider Name (Legal Business Name): CMH HOME FUND MGR
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/28/2024
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
888 VIA ARROYO
VENTURA CA
93003-1319
US
IV. Provider business mailing address
888 VIA ARROYO
VENTURA CA
93003-1319
US
V. Phone/Fax
- Phone: 805-561-6316
- Fax:
- Phone: 805-561-6316
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0850X |
| Taxonomy | Adult Mental Health Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 323P00000X |
| Taxonomy | Psychiatric Residential Treatment Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KATHERINE
DANDLEY
Title or Position: PROGRAM DIRECTOR
Credential:
Phone: 805-561-6316