Provider Demographics
NPI:1659043834
Name:FALLBROOK HEALTHCARE FOUNDATION
Entity Type:Organization
Organization Name:FALLBROOK HEALTHCARE FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SARGENT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-723-7570
Mailing Address - Street 1:PO BOX 2155
Mailing Address - Street 2:
Mailing Address - City:FALLBROOK
Mailing Address - State:CA
Mailing Address - Zip Code:92088-2155
Mailing Address - Country:US
Mailing Address - Phone:760-723-7570
Mailing Address - Fax:
Practice Address - Street 1:135 S MISSION RD
Practice Address - Street 2:
Practice Address - City:FALLBROOK
Practice Address - State:CA
Practice Address - Zip Code:92028-2869
Practice Address - Country:US
Practice Address - Phone:760-723-7570
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-05
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251X00000XAgenciesSupports Brokerage
No347E00000XTransportation ServicesTransportation Broker
No385H00000XRespite Care FacilityRespite Care