1205138518 NPI number — SALEM CHRISTIAN HOMES, INC.

Table of content: (NPI 1205138518)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205138518 NPI number — SALEM CHRISTIAN HOMES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SALEM CHRISTIAN HOMES, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
FARMER HOME
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1205138518
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/19/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6921 EDISON AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHINO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91710-9057
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
909-614-0575
Provider Business Mailing Address Fax Number:
909-614-0594

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1177 ASTER AVENUE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
UPLAND
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91786
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
909-614-0575
Provider Business Practice Location Address Fax Number:
909-614-0594
Provider Enumeration Date:
11/19/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
COPELAND
Authorized Official First Name:
DANIEL
Authorized Official Middle Name:
C
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
909-614-0575

Provider Taxonomy Codes

  • Taxonomy code: 320600000X , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)