=====================================================
General NPI Number Information
=====================================================
NPI Number | 1487019790
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | VFP HOMES, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/31/2015
-----------------------------------------------------
Last Update Date | 12/31/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6005 HARTMAN AVE
-----------------------------------------------------
City | BAKERSFIELD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93309-1925
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 661-332-7393
-----------------------------------------------------
Fax | 661-456-0161
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1527 19TH ST STE 216
-----------------------------------------------------
City | BAKERSFIELD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93301-4455
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 661-332-7393
-----------------------------------------------------
Fax | 661-456-0161
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | MR. PETER YUZON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 661-332-7393
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 320700000X
-----------------------------------------------------
Taxonomy Name | Physical Disabilities Residential Treatment Facility
-----------------------------------------------------
License Number | 550003276
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------