Organization Name: | PSB HOMES INC. DRACAENA HOMES |
NPI Number: | 1003245499 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | PRISCILLA BUSTAMANTE (OWNER/ADMINISTRATOR) |
Mailing Address: | 8241 Dracaena Dr Buena Park |
State: | CA US |
Postal Code: | 906204014 |
Phone Number: | 7148266652 |
Fax Number: | 7147797268 |
NPI Enumeration Date: | 11/05/2013 |
NPI Last Update Date: | 11/05/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320600000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
Taxonomy Specialization: | |
Taxonomy Definition: | A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |