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General NPI Number Information
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NPI Number | 1295151710
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Entity Type | Organization
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Legal Business Name | ZUHA HOMES, INC
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Dates
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Enumeration Date | 03/07/2014
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Last Update Date | 03/07/2014
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Provider Practice Location Address
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Address Line | 13881 COBBLESTONE CT
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City | FONTANA
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State | CA
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Zip | 92335-0504
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Country | US
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Telephone | 909-258-6349
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Fax | 909-874-6711
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Provider Business Mailing Address
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Address Line | 13881 COBBLESTONE CT
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City | FONTANA
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State | CA
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Zip | 92335-0504
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Country | US
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Telephone | 909-258-6349
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Fax | 909-874-6711
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | SRIADI SUTJININGSIH
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Credential |
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Telephone | 909-258-6349
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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 |
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License Number State | CA
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