Provider Demographics
NPI:1023789468
Name:CASA DE AMIGOS COMMUNITY RESPITE CENTER, INC.
Entity type:Organization
Organization Name:CASA DE AMIGOS COMMUNITY RESPITE CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY/ TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-428-8453
Mailing Address - Street 1:528 MONTEREY ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93305-4305
Mailing Address - Country:US
Mailing Address - Phone:661-633-0226
Mailing Address - Fax:661-322-1532
Practice Address - Street 1:528 MONTEREY ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93305-4305
Practice Address - Country:US
Practice Address - Phone:661-633-0226
Practice Address - Fax:661-322-1532
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-24
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home