Provider Demographics
NPI:1255755237
Name:CALOAKS CARE GROUP INC
Entity type:Organization
Organization Name:CALOAKS CARE GROUP INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:S
Authorized Official - Last Name:CHARNETSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-315-6057
Mailing Address - Street 1:3891 POLK ST
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92505-1703
Mailing Address - Country:US
Mailing Address - Phone:951-689-6162
Mailing Address - Fax:951-689-6182
Practice Address - Street 1:3891 POLK ST
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92505-1703
Practice Address - Country:US
Practice Address - Phone:951-689-6162
Practice Address - Fax:951-689-6182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-11
Last Update Date:2014-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA336426029310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility