Provider Demographics
NPI:1902179609
Name:MCGUIRES GUEST HOME INC.
Entity Type:Organization
Organization Name:MCGUIRES GUEST HOME INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:LEA
Authorized Official - Last Name:MCKAY
Authorized Official - Suffix:
Authorized Official - Credentials:ADMIT CERT
Authorized Official - Phone:916-944-7447
Mailing Address - Street 1:3442 CALIFORNIA AVE
Mailing Address - Street 2:
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-3474
Mailing Address - Country:US
Mailing Address - Phone:916-944-7447
Mailing Address - Fax:916-944-3124
Practice Address - Street 1:3442 CALIFORNIA AVE
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-3474
Practice Address - Country:US
Practice Address - Phone:916-944-7447
Practice Address - Fax:916-944-3124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-12
Last Update Date:2012-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA347003336310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility