Organization Active NPI

David & Margaret Home, Inc.

  • Community/Behavioral Health Agency
  • La Verne, CA
National Provider Identifier
1407917784
Registry record updated Aug 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
7566A Issued in CA
Legal business name
DAVID & MARGARET HOME, INC.
Practice address
1350 3Rd St
La Verne, CA 91750-5201
Phone
(909) 596-5921
Fax
(909) 596-3954
NPI assigned
Dec 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2015

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

Authorized official

Name
Mr. Charles Rich, LCSW
Title
Executive Director
Phone
(909) 596-5921

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 7566A CA Primary

Addresses

Primary practice location

1350 3Rd St
La Verne, CA 91750-5201

Mailing address

1350 3Rd St
La Verne, CA 91750-5201
Phone (909) 596-5921

Other identifiers 1

IdentifierTypeStateIssuer
01227MedicaidCA

Other names 1

  • David & Margaret Home, Inc. Doing business as

National Provider Directory

National Provider Directory
Tax ID family
David Margaret Home Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439856000000",
    "number": "1407917784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 3RD ST",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "917505201",
            "telephone_number": "909-596-5921",
            "fax_number": "909-596-3954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 3RD ST",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "917505201",
            "telephone_number": "909-596-5921",
            "fax_number": "909-596-3954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID & MARGARET HOME, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2015-08-18",
        "status": "A",
        "authorized_official_last_name": "RICH",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "909-596-5921",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "7566A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01227",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "David & Margaret Home, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in La Verne, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2015; 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.