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General NPI Number Information
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NPI Number | 1659624005
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Entity Type | Organization
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Legal Business Name | HEMPSTEAD RESIDENTIAL CARE, INC.
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Dates
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Enumeration Date | 10/23/2012
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Last Update Date | 10/23/2012
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Provider Practice Location Address
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Address Line | 3105 HEMPSTEAD RD
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City | SACRAMENTO
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State | CA
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Zip | 95864-7707
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Country | US
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Telephone | 916-485-7420
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Fax | 916-485-7410
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Provider Business Mailing Address
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Address Line | PO BOX 214664
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City | SACRAMENTO
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State | CA
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Zip | 95821-0664
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Country | US
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Telephone | 916-451-0444
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Fax | 916-451-0333
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. FRANS ROODENBURG
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Credential |
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Telephone | 916-451-0444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3104A0630X
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Taxonomy Name | Assisted Living Facility (Behavioral Disturbances)
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License Number | 347-001-384
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License Number State | CA
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