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General NPI Number Information
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NPI Number | 1619042835
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Entity Type | Organization
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Legal Business Name | CERRITOS HOME CARE INC
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Dates
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Enumeration Date | 11/22/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 11541 BINGHAM STREET
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City | CERRITOS
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State | CA
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Zip | 90703-6771
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Country | US
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Telephone | 562-860-3057
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Fax | 562-860-3084
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Provider Business Mailing Address
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Address Line | 11541 BINGHAM STREET
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City | CERRITOS
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State | CA
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Zip | 90703-6771
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Country | US
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Telephone | 562-860-3057
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Fax | 562-860-3084
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Authorized Official
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Title or Position | ADMINISTRATOR LICENSEE
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Name | MRS. EDITH PARRENO
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Credential |
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Telephone | 562-761-9319
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State | CA
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