Provider Demographics
NPI:1598948036
Name:ALLELUIA
Entity Type:Organization
Organization Name:ALLELUIA
Other - Org Name:HOLLYWOOD HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:DALE
Authorized Official - Middle Name:W
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-638-6640
Mailing Address - Street 1:1630 E MANNING AVE
Mailing Address - Street 2:
Mailing Address - City:REEDLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93654-2385
Mailing Address - Country:US
Mailing Address - Phone:559-638-6640
Mailing Address - Fax:559-638-4311
Practice Address - Street 1:405 W HOLLYWOOD CT
Practice Address - Street 2:
Practice Address - City:REEDLEY
Practice Address - State:CA
Practice Address - Zip Code:93654-2154
Practice Address - Country:US
Practice Address - Phone:559-638-6640
Practice Address - Fax:559-638-4311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-06
Last Update Date:2007-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities