MEDICARE: ANGEL VIEW CRIPPLED CHILDRENS FOUNDATION INC

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538206388
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANGEL VIEW CRIPPLED CHILDRENS FOUNDATION INC

Provider Business Mailing Address
First Line	:	12379 MIRACLE HILL ROAD
Second Line	:
City	:	DESERT HOT SPRINGS
State	:	CA
Zip	:	92240-4010
Country	:	US
Telephone Number	:	760-329-6471
Fax Number	:	760-329-9024

Provider Business Practice Location Address
First Line	:	30 400 DESERT PALM DRIVE
Second Line	:
City	:	THOUSAND PALMS
State	:	CA
Zip	:	92276
Country	:	US
Telephone Number	:	760-329-6471
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MR. DAVID C THORNTON
Credential	:
Telephone Number	:	760-329-6471

Provider Enumeration Date	:	01/31/2007
Last Update Date	:	08/22/2020

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