Provider Demographics
NPI:1649565458
Name:CHATEAU DOMESTICS, INC.
Entity Type:Organization
Organization Name:CHATEAU DOMESTICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:NORA
Authorized Official - Middle Name:CELESTIAL
Authorized Official - Last Name:MAMINTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-506-5297
Mailing Address - Street 1:3505 LONG BEACH BLVD
Mailing Address - Street 2:SUITE 2C
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-3907
Mailing Address - Country:US
Mailing Address - Phone:562-426-9139
Mailing Address - Fax:562-426-9146
Practice Address - Street 1:3505 LONG BEACH BLVD
Practice Address - Street 2:SUITE 2C
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-3907
Practice Address - Country:US
Practice Address - Phone:562-426-9139
Practice Address - Fax:562-426-9146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-09
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home