Provider Demographics
NPI:1518317205
Name:CHERI'S CARE
Entity Type:Organization
Organization Name:CHERI'S CARE
Other - Org Name:TLC CARE HOMES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TONY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHRISTENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-425-5372
Mailing Address - Street 1:7231 BOULDER AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:HIGHLAND
Mailing Address - State:CA
Mailing Address - Zip Code:92346-3313
Mailing Address - Country:US
Mailing Address - Phone:909-425-5372
Mailing Address - Fax:909-425-9281
Practice Address - Street 1:7231 BOULDER AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:HIGHLAND
Practice Address - State:CA
Practice Address - Zip Code:92346-3313
Practice Address - Country:US
Practice Address - Phone:909-425-5372
Practice Address - Fax:909-425-9281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-14
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA366427412320900000X
CA366427413320900000X
CA366427414320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities