Provider Demographics
NPI:1770857583
Name:C AND D'S GUEST HOMES, INC
Entity Type:Organization
Organization Name:C AND D'S GUEST HOMES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHANTE
Authorized Official - Middle Name:LYNETTE
Authorized Official - Last Name:DOBBINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-769-4541
Mailing Address - Street 1:PO BOX 1465
Mailing Address - Street 2:
Mailing Address - City:ATWATER
Mailing Address - State:CA
Mailing Address - Zip Code:95301-1465
Mailing Address - Country:US
Mailing Address - Phone:209-769-4541
Mailing Address - Fax:209-358-7348
Practice Address - Street 1:2585 ROSELLE DR
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95348-3802
Practice Address - Country:US
Practice Address - Phone:209-769-4541
Practice Address - Fax:209-358-7348
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-27
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA247204068320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities