Provider Demographics
NPI:1194002170
Name:FOOTHILL RCF, INC.
Entity Type:Organization
Organization Name:FOOTHILL RCF, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FINANCIAL SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:MELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:CADABES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-273-8904
Mailing Address - Street 1:6720 SAINT ESTABAN ST
Mailing Address - Street 2:
Mailing Address - City:TUJUNGA
Mailing Address - State:CA
Mailing Address - Zip Code:91042-3335
Mailing Address - Country:US
Mailing Address - Phone:818-353-3350
Mailing Address - Fax:818-353-4771
Practice Address - Street 1:6720 SAINT ESTABAN ST
Practice Address - Street 2:
Practice Address - City:TUJUNGA
Practice Address - State:CA
Practice Address - Zip Code:91042-3335
Practice Address - Country:US
Practice Address - Phone:818-353-3350
Practice Address - Fax:818-353-4771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-04
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA197607570310400000X, 311500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
197607570OtherSTATE FACILITY LICENSE NUMBER