Provider Demographics
NPI:1477208700
Name:ALL OF GOD'S CHILDREN'S GROUP HOME
Entity Type:Organization
Organization Name:ALL OF GOD'S CHILDREN'S GROUP HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:WILLIAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-232-3062
Mailing Address - Street 1:28108 BELFRY CIRCLE
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92555
Mailing Address - Country:US
Mailing Address - Phone:951-232-3062
Mailing Address - Fax:951-924-4704
Practice Address - Street 1:28108 BELFRY CIRCLE
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92555
Practice Address - Country:US
Practice Address - Phone:951-247-0233
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-15
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty