Provider Demographics
NPI:1619042835
Name:CERRITOS HOME CARE INC
Entity Type:Organization
Organization Name:CERRITOS HOME CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR LICENSEE
Authorized Official - Prefix:MRS
Authorized Official - First Name:EDITH
Authorized Official - Middle Name:
Authorized Official - Last Name:PARRENO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-761-9319
Mailing Address - Street 1:11541 BINGHAM STREET
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-6771
Mailing Address - Country:US
Mailing Address - Phone:562-860-3057
Mailing Address - Fax:562-860-3084
Practice Address - Street 1:11541 BINGHAM STREET
Practice Address - Street 2:
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703-6771
Practice Address - Country:US
Practice Address - Phone:562-860-3057
Practice Address - Fax:562-860-3084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities