Provider Demographics
NPI:1467931683
Name:CHENEY HOMES INC
Entity Type:Organization
Organization Name:CHENEY HOMES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/RN
Authorized Official - Prefix:
Authorized Official - First Name:RITA
Authorized Official - Middle Name:
Authorized Official - Last Name:REGINALDO-ROXAS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:510-861-2635
Mailing Address - Street 1:1755 CANTERBURY LN
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94544-8710
Mailing Address - Country:US
Mailing Address - Phone:510-861-2635
Mailing Address - Fax:510-784-0294
Practice Address - Street 1:1644 CHENEY LN
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94545-4331
Practice Address - Country:US
Practice Address - Phone:510-670-0239
Practice Address - Fax:510-784-0294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-08
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities