1710941141 NPI number — HOME OF GUIDING HANDS

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710941141 NPI number — HOME OF GUIDING HANDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOME OF GUIDING HANDS
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:
WINDMILL VIEW
Provider Other Organization Name Type Code:
5
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:
1710941141
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1825 GILLESPIE WAY
Provider Second Line Business Mailing Address:
#200
Provider Business Mailing Address City Name:
EL CAJON
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92020-0501
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
619-938-2850
Provider Business Mailing Address Fax Number:
619-938-3051

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1825 GILLESPIE WAY
Provider Second Line Business Practice Location Address:
#200
Provider Business Practice Location Address City Name:
EL CAJON
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92020-0501
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-938-2850
Provider Business Practice Location Address Fax Number:
619-938-3051
Provider Enumeration Date:
04/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ADAMS
Authorized Official First Name:
JAN
Authorized Official Middle Name:
S
Authorized Official Title or Position:
DIRECTOR OF FINANCE
Authorized Official Telephone Number:
619-938-2864

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)

  • Identifier: LTC60223F , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




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