Provider Demographics
NPI:1982862132
Name:SALEM CHRISTIAN HOMES, INC
Entity Type:Organization
Organization Name:SALEM CHRISTIAN HOMES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:COPELAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-947-3761
Mailing Address - Street 1:6921 EDISON AVE
Mailing Address - Street 2:
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-9057
Mailing Address - Country:US
Mailing Address - Phone:909-947-3761
Mailing Address - Fax:909-930-9880
Practice Address - Street 1:708 MANZANITA CT
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91762-6328
Practice Address - Country:US
Practice Address - Phone:909-391-6423
Practice Address - Fax:909-673-0048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-23
Last Update Date:2008-08-05
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