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General NPI Number Information
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NPI Number | 1083859094
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Entity Type | Organization
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Legal Business Name | C & R GUEST HOMES, INC.
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Dates
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Enumeration Date | 12/04/2008
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Last Update Date | 12/04/2008
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Provider Practice Location Address
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Address Line | 5581 MONTICELLO AVE
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City | BUENA PARK
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State | CA
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Zip | 90621-1543
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Country | US
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Telephone | 714-670-1139
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Fax | 714-739-4371
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Provider Business Mailing Address
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Address Line | 7694 HEATHER CIR
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City | BUENA PARK
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State | CA
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Zip | 90620-1924
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Country | US
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Telephone | 714-496-9990
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Fax | 714-739-4371
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Authorized Official
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Title or Position | LICENSEE/ADMINISTRATOR
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Name | MRS. ROSALINDA C ULIT
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Credential |
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Telephone | 714-496-9990
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number | 5550000600
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License Number State | CA
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