Provider Demographics
NPI:1609190792
Name:CALIFORNIA DRUG CONSULTANTS, INC.
Entity Type:Organization
Organization Name:CALIFORNIA DRUG CONSULTANTS, INC.
Other - Org Name:INTEGRATED CARE COMMUNITIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:E
Authorized Official - Last Name:ROWE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:951-243-3837
Mailing Address - Street 1:11751 DAVIS ST
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92557-6316
Mailing Address - Country:US
Mailing Address - Phone:951-243-3837
Mailing Address - Fax:951-485-2642
Practice Address - Street 1:14345 NASON ST
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92555-4727
Practice Address - Country:US
Practice Address - Phone:951-247-6115
Practice Address - Fax:951-247-5611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-18
Last Update Date:2010-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA336405887310400000X, 311500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility