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NPI Code Detail

MEDICARE: GARCES RESIDENTIAL CARE SERVICES

MEDICARE: GARCES RESIDENTIAL CARE SERVICES
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
1253J00000XFoster Care Agency
2261QM0855XAdolescent and Children Mental Health Clinic/Center

General Provider Information

NPI Number : 1356984264
Entity Type Code : Organization
Provider Name (Legal Business Name) : GARCES RESIDENTIAL CARE SERVICES
Provider Business Mailing Address
First Line : 7349 MILLIKEN AVE # 140-223
Second Line :
City : RANCHO CUCAMONGA
State : CA
Zip : 91730-7435
Country : US
Telephone Number : 909-646-9509
Fax Number : 909-646-9508
Provider Business Practice Location Address
First Line : 7349 MILLIKEN AVE # 140-223
Second Line :
City : RANCHO CUCAMONGA
State : CA
Zip : 91730-7435
Country : US
Telephone Number : 909-646-9509
Fax Number : 909-646-9508
Authorized Official
Title or Position : PRESIDENT/CEO
Name : MR. CARLOS ALBERTO GARCES
Credential :
Telephone Number : 909-376-6619
Provider Enumeration Date : 10/23/2019
Last Update Date : 10/23/2019

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Directions to “GARCES RESIDENTIAL CARE SERVICES ” Practice Location

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