Provider Demographics
NPI:1750099784
Name:CHOUDRY FAMILY CORPORATION
Entity type:Organization
Organization Name:CHOUDRY FAMILY CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAHER
Authorized Official - Middle Name:A
Authorized Official - Last Name:CHOUDRY
Authorized Official - Suffix:
Authorized Official - Credentials:ADMINISTRATOR
Authorized Official - Phone:951-522-1425
Mailing Address - Street 1:4879 WESTMONT ST
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92507-7704
Mailing Address - Country:US
Mailing Address - Phone:951-522-1425
Mailing Address - Fax:
Practice Address - Street 1:84701 VELIERO CT
Practice Address - Street 2:
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92203-2938
Practice Address - Country:US
Practice Address - Phone:951-522-1425
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-08
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances