MEDICARE: HORRIGAN ENTERPRISES, INC., ROBINSON HOUSE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	315P00000X	Intellectual Disabilities Intermediate Care Facility		CA

General Provider Information

NPI Number	:	1225187289
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HORRIGAN ENTERPRISES, INC., ROBINSON HOUSE

Provider Business Mailing Address
First Line	:	25787 MESA CT
Second Line	:
City	:	SAN BERNARDINO
State	:	CA
Zip	:	92404-3074
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	25787 MESA CT
Second Line	:
City	:	SAN BERNARDINO
State	:	CA
Zip	:	92404-3074
Country	:	US
Telephone Number	:	909-484-5561
Fax Number	:

Authorized Official
Title or Position	:	DIR OF ADMN SERVICES
Name	:	CAROL TIPTON
Credential	:
Telephone Number	:	909-484-5561

Provider Enumeration Date	:	01/09/2007
Last Update Date	:	08/22/2020

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