Provider Demographics
NPI:1275245649
Name:A HOME FOR MOM & DAD, INC
Entity Type:Organization
Organization Name:A HOME FOR MOM & DAD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:AMANTE
Authorized Official - Middle Name:BORDEY
Authorized Official - Last Name:APOLINARIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-998-9360
Mailing Address - Street 1:44856 33RD ST W
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93536-8394
Mailing Address - Country:US
Mailing Address - Phone:661-998-9360
Mailing Address - Fax:991-579-6759
Practice Address - Street 1:44856 33RD ST W
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93536-8394
Practice Address - Country:US
Practice Address - Phone:661-998-9360
Practice Address - Fax:991-579-6759
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-16
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility