Bradford Residential Care Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

BRADFORD RESIDENTIAL CARE INC.

Doing business as

Bradford Residential Care Inc.

Practice address

1111 Bradford Dr
Glendora, CA 91740-5303

Phone

(626) 233-7489

Fax

(626) 609-7510

NPI assigned

Sep 13, 2023

Last updated

Sep 13, 2023By 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

Mr. Humberto Santamaria

Title

Administrator

Phone

(626) 233-7489

Specialties & licenses 1

Addresses

Other names 1

• Bradford Residential Care Inc. Doing business as

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

{
    "created_epoch": "1694563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694563200000",
    "number": "1538946306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 BRADFORD DR",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917405303",
            "telephone_number": "626-233-7489",
            "fax_number": "626-609-7510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 BRADFORD DR",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917405303",
            "telephone_number": "626-233-7489",
            "fax_number": "626-609-7510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADFORD RESIDENTIAL CARE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-13",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A",
        "authorized_official_last_name": "SANTAMARIA",
        "authorized_official_first_name": "HUMBERTO",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "626-233-7489",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bradford Residential Care Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Guadalupe Garcia Boudreaux, APCC
• Najib Bouz, M.D.
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• Kirsten Ashley-Marie Brandenburg, LMFT
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• Assisted Living Facility in Glendora, CA
• Providers in Glendora, CA by specialty
• Assisted Living Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2023; 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.