Provider Demographics
NPI:1437640372
Name:MURPHY'S BOYS GROUP HOME
Entity Type:Organization
Organization Name:MURPHY'S BOYS GROUP HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:HILLARY
Authorized Official - Last Name:NICHOLSON
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:760-410-2367
Mailing Address - Street 1:13312 RANCHERO RD
Mailing Address - Street 2:
Mailing Address - City:OAK HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92344-4812
Mailing Address - Country:US
Mailing Address - Phone:760-410-2367
Mailing Address - Fax:
Practice Address - Street 1:3509 EISENHOWER AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-6102
Practice Address - Country:US
Practice Address - Phone:661-831-1288
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-26
Last Update Date:2018-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children