Provider Demographics
NPI:1841056322
Name:CHARMONY FOUNDATION INC
Entity type:Organization
Organization Name:CHARMONY FOUNDATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:AGAEZI
Authorized Official - Middle Name:
Authorized Official - Last Name:SONYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-440-4083
Mailing Address - Street 1:23811 WASHINGTON AVE STE C110-259
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-2275
Mailing Address - Country:US
Mailing Address - Phone:951-440-4083
Mailing Address - Fax:
Practice Address - Street 1:26442 BECKMAN CT
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-7022
Practice Address - Country:US
Practice Address - Phone:951-226-1846
Practice Address - Fax:951-226-1728
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-22
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite CareGroup - Multi-Specialty