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General NPI Number Information
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NPI Number | 1376080218
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Entity Type | Organization
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Legal Business Name | FERREES GROUP HOME, INC
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Dates
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Enumeration Date | 01/30/2017
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Last Update Date | 02/25/2021
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Provider Practice Location Address
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Address Line | 860 S 22ND ST
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City | BANNING
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State | CA
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Zip | 92220-4214
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Country | US
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Telephone | 951-922-3554
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Fax | 951-849-8516
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Provider Business Mailing Address
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Address Line | PO BOX 570
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City | CABAZON
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State | CA
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Zip | 92230-0570
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Country | US
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Telephone | 951-922-3554
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Fax | 951-849-8516
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | PHILLIP FERREE
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Credential |
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Telephone | 909-322-5686
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number |
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License Number State |
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