Provider Demographics
NPI:1881344018
Name:FOOTHILL HOUSE OF HOSPITALITY
Entity type:Organization
Organization Name:FOOTHILL HOUSE OF HOSPITALITY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:SIERRA
Authorized Official - Last Name:BAGLIETTO
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:530-615-0807
Mailing Address - Street 1:1262 SUTTON WAY
Mailing Address - Street 2:
Mailing Address - City:GRASS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95945-5175
Mailing Address - Country:US
Mailing Address - Phone:530-271-7144
Mailing Address - Fax:530-205-9203
Practice Address - Street 1:131 GLENWOOD AVE
Practice Address - Street 2:
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95945-7891
Practice Address - Country:US
Practice Address - Phone:530-271-7144
Practice Address - Fax:530-205-9203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-29
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251X00000XAgenciesSupports Brokerage
No302R00000XManaged Care OrganizationsHealth Maintenance Organization
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No385H00000XRespite Care FacilityRespite Care