=====================================================
General NPI Number Information
=====================================================
NPI Number | 1578647731
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HOME CARE FORTE INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/24/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7908 QUILL DRIVE
-----------------------------------------------------
City | DOWNEY
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90242
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 562-861-6648
-----------------------------------------------------
Fax | 562-924-8829
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10938 ROBERTA STREET
-----------------------------------------------------
City | CERRITOS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90703
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 562-402-3331
-----------------------------------------------------
Fax | 562-924-8829
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER LICENSEE
-----------------------------------------------------
Name | MRS. CASILDA P JOSE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 562-402-3331
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 320600000X
-----------------------------------------------------
Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------