Provider Demographics
NPI:1659624005
Name:HEMPSTEAD RESIDENTIAL CARE, INC.
Entity Type:Organization
Organization Name:HEMPSTEAD RESIDENTIAL CARE, INC.
Other - Org Name:HEMPSTEAD HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANS
Authorized Official - Middle Name:
Authorized Official - Last Name:ROODENBURG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-451-0444
Mailing Address - Street 1:PO BOX 214664
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95821-0664
Mailing Address - Country:US
Mailing Address - Phone:916-451-0444
Mailing Address - Fax:916-451-0333
Practice Address - Street 1:3105 HEMPSTEAD RD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95864-7707
Practice Address - Country:US
Practice Address - Phone:916-485-7420
Practice Address - Fax:916-485-7410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-23
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA347-001-3843104A0630X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances