Provider Demographics
NPI:1710201439
Name:PARTRIDGE FAMILY HOMES
Entity Type:Organization
Organization Name:PARTRIDGE FAMILY HOMES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:PARTRIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-429-4434
Mailing Address - Street 1:21937 GRESHAM ST
Mailing Address - Street 2:
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91304-1318
Mailing Address - Country:US
Mailing Address - Phone:818-429-4434
Mailing Address - Fax:818-346-0207
Practice Address - Street 1:18701 TULSA ST
Practice Address - Street 2:
Practice Address - City:PORTER RANCH
Practice Address - State:CA
Practice Address - Zip Code:91326-2717
Practice Address - Country:US
Practice Address - Phone:818-429-4434
Practice Address - Fax:818-346-0207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-24
Last Update Date:2010-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA197603514311500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)