Provider Demographics
NPI:1649778952
Name:MURRELL'S FARM AND BOYS HOME
Entity Type:Organization
Organization Name:MURRELL'S FARM AND BOYS HOME
Other - Org Name:MURRELL'S FARM CEDAR
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:EMMETT
Authorized Official - Middle Name:
Authorized Official - Last Name:MURRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-942-2035
Mailing Address - Street 1:43862 CEDAR AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-5043
Mailing Address - Country:US
Mailing Address - Phone:661-942-2035
Mailing Address - Fax:661-942-2068
Practice Address - Street 1:43862 CEDAR AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-5043
Practice Address - Country:US
Practice Address - Phone:661-942-2035
Practice Address - Fax:661-942-2068
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MURRELL'S FARM AND BOYS HOME
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-02-01
Last Update Date:2018-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA198208228322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children