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General NPI Number Information
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NPI Number | 1770857583
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Entity Type | Organization
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Legal Business Name | C AND D'S GUEST HOMES, INC
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Dates
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Enumeration Date | 02/27/2012
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Last Update Date | 02/27/2012
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Provider Practice Location Address
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Address Line | 2585 ROSELLE DR
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City | MERCED
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State | CA
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Zip | 95348-3802
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Country | US
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Telephone | 209-769-4541
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Fax | 209-358-7348
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Provider Business Mailing Address
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Address Line | PO BOX 1465
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City | ATWATER
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State | CA
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Zip | 95301-1465
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Country | US
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Telephone | 209-769-4541
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Fax | 209-358-7348
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Authorized Official
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Title or Position | OWNER
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Name | MS. CHANTE LYNETTE DOBBINS
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Credential |
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Telephone | 209-769-4541
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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 | 247204068
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License Number State | CA
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