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General NPI Number Information
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NPI Number | 1013454289
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Entity Type | Organization
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Legal Business Name | A CARING HEART RESIDENCE, INC.
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Dates
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Enumeration Date | 01/26/2017
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Last Update Date | 01/26/2017
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Provider Practice Location Address
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Address Line | 371 E MILLAN ST
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City | CHULA VISTA
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State | CA
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Zip | 91910-6313
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Country | US
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Telephone | 619-361-2344
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Fax |
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Provider Business Mailing Address
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Address Line | 371 EAST MILLAN STREET
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City | CHULA VISTA
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State | CA
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Zip | 91910
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Country | US
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Telephone | 619-361-2344
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. MONICA ROBLEDO ALLAN
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Credential |
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Telephone | 619-361-2344
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311Z00000X
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Taxonomy Name | Custodial Care Facility
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License Number | 374603888
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License Number State | CA
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