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General NPI Number Information
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NPI Number | 1306991278
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Entity Type | Organization
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Legal Business Name | KAISER FOUNDATION HOSPITALS
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 04/20/2021
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Provider Practice Location Address
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Address Line | 17046 MARYGOLD AVE
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City | FONTANA
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State | CA
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Zip | 92335-1706
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Country | US
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Telephone | 909-427-5128
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Fax |
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Provider Business Mailing Address
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Address Line | 17046 MARYGOLD AVE
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City | FONTANA
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State | CA
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Zip | 92335-1706
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Country | US
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Telephone | 909-427-5128
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Fax |
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Authorized Official
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Title or Position | INTERIM DIRECTOR ARL
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Name | RUTH COUNTS
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Credential | MHA, RN, CPHQ
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Telephone | 626-405-3676
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | 240000159
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License Number State | CA
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