3Faces Ranch, LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

License

197609078 Issued in CA

Legal business name

3FACES RANCH, LLC

Practice address

2039 W Avenue M12
Palmdale, CA 93551-1710

Phone

(310) 749-3737

NPI assigned

Dec 1, 2017

Last updated

Dec 1, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Raji Rykert, M.B.A.

Title

Business Manager

Phone

(310) 749-3737

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1512086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512086400000",
    "number": "1265946065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2851 W AVENUE L STE 313",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935364022",
            "telephone_number": "661-480-0912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2039 W AVENUE M12",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935511710",
            "telephone_number": "310-749-3737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "3FACES RANCH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-01",
        "last_updated": "2017-12-01",
        "status": "A",
        "authorized_official_last_name": "RYKERT",
        "authorized_official_first_name": "RAJI",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "310-749-3737",
        "authorized_official_credential": "M.B.A."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "CA",
            "license": "197609078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2017; 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.