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General NPI Number Information
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NPI Number | 1770741241
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Entity Type | Organization
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Legal Business Name | ROGER'S HOME, INC.
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Dates
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Enumeration Date | 05/30/2008
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Last Update Date | 05/30/2008
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Provider Practice Location Address
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Address Line | 27180 ROGER ST
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City | HEMET
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State | CA
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Zip | 92544-8312
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Country | US
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Telephone | 951-652-9712
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Fax | 951-658-1840
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Provider Business Mailing Address
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Address Line | 9835 WILEY BURKE AVE
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City | DOWNEY
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State | CA
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Zip | 90240-3713
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Country | US
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Telephone | 562-927-8043
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Fax | 951-658-1840
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ALFREDO MENDOZA ILAGAN
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Credential |
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Telephone | 951-733-0762
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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