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General NPI Number Information
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NPI Number | 1477208700
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Entity Type | Organization
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Legal Business Name | ALL OF GOD'S CHILDREN'S GROUP HOME
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Dates
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Enumeration Date | 02/15/2022
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Last Update Date | 02/15/2022
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Provider Practice Location Address
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Address Line | 28108 BELFRY CIRCLE
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City | MORENO VALLEY
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State | CA
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Zip | 92555
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Country | US
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Telephone | 951-247-0233
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Fax |
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Provider Business Mailing Address
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Address Line | 28108 BELFRY CIRCLE
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City | MORENO VALLEY
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State | CA
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Zip | 92555
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Country | US
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Telephone | 951-232-3062
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Fax | 951-924-4704
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Authorized Official
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Title or Position | PRESIDENT, DIRECTOR
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Name | MRS. CHERYL JEAN WILLIAMSON
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Credential |
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Telephone | 951-232-3062
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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