Roberts Group Home Inc

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

191501024 Issued in CA

Legal business name

ROBERTS GROUP HOME INC

Practice address

1435 East Grand Ave
Pomona, CA 91766

Phone

(909) 623-3353

Fax

(909) 623-1143

NPI assigned

Aug 20, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Hazel Gertrude Roberts, PERSONAL CARE PROVID

Title

Owner/President

Phone

(909) 623-3353

Specialties & licenses 3

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1250726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250726400000",
    "number": "1124250378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1435 EAST GRAND AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "91766",
            "telephone_number": "909-623-3353",
            "fax_number": "909-623-1143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1435 EAST GRAND AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "91766",
            "telephone_number": "909-623-3353",
            "fax_number": "909-623-1143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERTS GROUP HOME INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-20",
        "last_updated": "2009-08-20",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "HAZEL",
        "authorized_official_middle_name": "GERTRUDE",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "909-623-3353",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PERSONAL CARE PROVID"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "CA",
            "license": "191501024",
            "primary": true
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "CA",
            "license": "360906027",
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "CA",
            "license": "191592141",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Esther Maria Roa, ACSW
• Isamar Roa
• Ashleigh Briana Roberson
• Robert Busuttil
• Nmesoma Deborah Robert
• Laura Roberts
• Brian Arthur Robertson, MS, PA-C
• Samantha Robertson
• Akiah Tenee Robinson Selwa, LMFT
• Alexandria Robinson

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Pomona, CA
• Providers in Pomona, CA by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.