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NPI Code Detail

MEDICARE: COMMITTED HEARTS RESIDENTIAL HOMES, LLC

MEDICARE: COMMITTED HEARTS RESIDENTIAL HOMES, LLC
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
1320600000XIntellectual and/or Developmental Disabilities Residential Treatment Facility

General Provider Information

NPI Number : 1780512103
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMMITTED HEARTS RESIDENTIAL HOMES, LLC
Provider Business Mailing Address
First Line : 11 DUNFIRTH DR
Second Line :
City : HAYWARD
State : CA
Zip : 94542-7942
Country : US
Telephone Number : 614-975-5257
Fax Number :
Provider Business Practice Location Address
First Line : 600 WAPELLO CIR
Second Line :
City : SACRAMENTO
State : CA
Zip : 95835-1866
Country : US
Telephone Number : 925-470-5010
Fax Number :
Authorized Official
Title or Position : CHIEF OPERATING OFFICER
Name : MR. KWAME A FIELDS SR.
Credential : CISSP
Telephone Number : 614-975-5257
Provider Enumeration Date : 05/13/2026
Last Update Date : 05/13/2026

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Directions to “COMMITTED HEARTS RESIDENTIAL HOMES, LLC ” Practice Location

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