1437367604 NPI number — TUSCANY HILLS HEALTH CARE SERVICES INC

Table of content: (NPI 1437367604)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437367604 NPI number — TUSCANY HILLS HEALTH CARE SERVICES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TUSCANY HILLS HEALTH CARE SERVICES 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:
Provider Other Organization Name Type Code:
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:
1437367604
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/03/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
232 E GRAND BLVD
Provider Second Line Business Mailing Address:
STE 104
Provider Business Mailing Address City Name:
CORONA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92879-1532
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
951-279-9995
Provider Business Mailing Address Fax Number:
951-279-1678

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
232 E GRAND BLVD
Provider Second Line Business Practice Location Address:
STE 104
Provider Business Practice Location Address City Name:
CORONA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92879-1532
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
951-279-9995
Provider Business Practice Location Address Fax Number:
951-279-1678
Provider Enumeration Date:
05/19/2007

Additional Information

Authorized Official

Authorized Official Last Name:
VALMORES
Authorized Official First Name:
LETICIA
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
951-279-9995

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  550000456 , 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: 550000456 . This is a "DHS LICENSE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 059225 . This is a "MEDICARE PROVIDER NUMBER" identifier . This identifiers is of the category "OTHER".




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