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General NPI Number Information
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NPI Number | 1295832665
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Entity Type | Organization
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Legal Business Name | AHWAHNEE CARE HOMES, INC.
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 444665 ROAD 619
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City | AHWAHNEE
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State | CA
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Zip | 93601
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Country | US
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Telephone | 559-658-2444
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Fax | 559-641-7898
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Provider Business Mailing Address
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Address Line | PO BOX 346
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City | AHWAHNEE
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State | CA
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Zip | 93601-0346
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Country | US
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Telephone | 559-658-2444
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Fax | 559-641-7898
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. LESLIE CLARKE STEVENS
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Credential | RN
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Telephone | 559-658-2444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 315P00000X
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Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
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License Number | 05G815
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 315P00000X
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Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
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License Number | 55G074
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 315P00000X
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Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
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License Number | 05G904
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License Number State | CA
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