Provider Demographics
NPI:1952545071
Name:AMERICAN BAPTIST HOMES OF THE WEST
Entity Type:Organization
Organization Name:AMERICAN BAPTIST HOMES OF THE WEST
Other - Org Name:VALLE VERDE ASSISTED LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RON
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHAEFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-687-1571
Mailing Address - Street 1:900 CALLE DE LOS AMIGOS
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-4435
Mailing Address - Country:US
Mailing Address - Phone:805-687-1571
Mailing Address - Fax:805-687-5540
Practice Address - Street 1:900 CALLE DE LOS AMIGOS
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-4435
Practice Address - Country:US
Practice Address - Phone:805-687-1571
Practice Address - Fax:805-687-5540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-21
Last Update Date:2009-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA421700411310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility