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General NPI Number Information
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NPI Number | 1578025102
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Entity Type | Organization
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Legal Business Name | HIS DAUGHTERS HOUSE
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Dates
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Enumeration Date | 04/02/2019
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Last Update Date | 10/18/2024
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Provider Practice Location Address
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Address Line | 11741 STERLING AVE STE C2
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City | RIVERSIDE
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State | CA
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Zip | 92503-4954
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Country | US
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Telephone | 951-729-6282
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Fax |
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Provider Business Mailing Address
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Address Line | 3870 LA SIERRA AVE UNIT 204
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City | RIVERSIDE
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State | CA
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Zip | 92505-3528
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Country | US
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Telephone | 562-572-9827
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ADRIANNE MASON
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Credential |
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Telephone | 951-729-6282
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174200000X
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Taxonomy Name | Meals Provider
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 332U00000X
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Taxonomy Name | Home Delivered Meals
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 177F00000X
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Taxonomy Name | Lodging Provider
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License Number |
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License Number State |
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