Provider Demographics
NPI:1861657660
Name:F & M ATIGA INC
Entity Type:Organization
Organization Name:F & M ATIGA INC
Other - Org Name:HILLSIDE BOARD AND CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:B
Authorized Official - Last Name:ATIGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-715-4463
Mailing Address - Street 1:15765 MONTANA AVE
Mailing Address - Street 2:
Mailing Address - City:LA PUENTE
Mailing Address - State:CA
Mailing Address - Zip Code:91744
Mailing Address - Country:US
Mailing Address - Phone:626-715-4462
Mailing Address - Fax:626-934-8640
Practice Address - Street 1:15765 MONTANA AVE
Practice Address - Street 2:
Practice Address - City:LA PUENTE
Practice Address - State:CA
Practice Address - Zip Code:91744
Practice Address - Country:US
Practice Address - Phone:626-715-4462
Practice Address - Fax:626-934-8640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-22
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA197606924311500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)