Provider Demographics
NPI:1336565308
Name:CHUQUIMIA'S ENTERPRISES INCORPORATED
Entity Type:Organization
Organization Name:CHUQUIMIA'S ENTERPRISES INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:LIDIA
Authorized Official - Middle Name:OLGA
Authorized Official - Last Name:CHUQUIMIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-776-9094
Mailing Address - Street 1:16465 PICK PL
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92504-5641
Mailing Address - Country:US
Mailing Address - Phone:951-789-2948
Mailing Address - Fax:
Practice Address - Street 1:16465 PICK PL
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92504-5641
Practice Address - Country:US
Practice Address - Phone:951-789-2948
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-13
Last Update Date:2014-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA336408330320600000X
CA336408331320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA90152422A37214Medicaid
CA90874633A85192Medicaid
CA95313448A15047Medicaid
CA90439088A95031Medicaid
CA91847614A05192Medicaid
CA92173381A85048Medicaid