Provider Demographics
NPI:1962463745
Name:HOME OF GUIDING HANDS
Entity Type:Organization
Organization Name:HOME OF GUIDING HANDS
Other - Org Name:CALDERA
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:MS
Authorized Official - First Name:JAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-938-2864
Mailing Address - Street 1:1825 GILLESPIE WAY
Mailing Address - Street 2:#200
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92020-0501
Mailing Address - Country:US
Mailing Address - Phone:619-938-2850
Mailing Address - Fax:619-938-3051
Practice Address - Street 1:1825 GILLESPIE WAY
Practice Address - Street 2:#200
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-0501
Practice Address - Country:US
Practice Address - Phone:619-938-2850
Practice Address - Fax:619-938-3051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALTC60454FMedicaid