Provider Demographics
NPI:1336997980
Name:PALOMINO RESIDENTIAL CARE INC.
Entity Type:Organization
Organization Name:PALOMINO RESIDENTIAL CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:PALOMINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-353-1167
Mailing Address - Street 1:1400 PIEDRA WAY
Mailing Address - Street 2:
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-5414
Mailing Address - Country:US
Mailing Address - Phone:323-353-1167
Mailing Address - Fax:
Practice Address - Street 1:1064 CHALET TER
Practice Address - Street 2:
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-3745
Practice Address - Country:US
Practice Address - Phone:323-353-1167
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-08
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility