Deboer Home #2

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

License

550001291 Issued in CA

Legal business name

DEBOER HOME #2

Practice address

2211 W Orange Ave
Porterville, CA 93257-7305

Phone

(559) 350-3695

Fax

(559) 793-2718

NPI assigned

Aug 27, 2010

Organization subpart

No

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

Authorized official

Name

Breann Deboer

Title

Licensee

Phone

(559) 350-3695

Specialties & licenses 1

Addresses

Tax ID family

Deboer Home2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Deboer Home

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Porterville, CA
  • NPI 1396932273
  NPD tax ID

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

{
    "created_epoch": "1282867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282867200000",
    "number": "1578879599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2211 W ORANGE AVENUE",
            "city": "PORTERVILLE",
            "state": "CA",
            "postal_code": "932577000",
            "telephone_number": "559-350-3695",
            "fax_number": "559-793-2718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 W ORANGE AVE",
            "city": "PORTERVILLE",
            "state": "CA",
            "postal_code": "932577305",
            "telephone_number": "559-350-3695",
            "fax_number": "559-793-2718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEBOER HOME #2",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-27",
        "last_updated": "2010-08-27",
        "status": "A",
        "authorized_official_last_name": "DEBOER",
        "authorized_official_first_name": "BREANN",
        "authorized_official_title_or_position": "LICENSEE",
        "authorized_official_telephone_number": "559-350-3695"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "CA",
            "license": "550001291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel & Max LLC
• David Heaney, M.D., Inc.
• Trina Rani Davis, RDHAP
• Gabriel Davoodpour
• Deboer Home
• Deboer Homes, Inc
• Deboer Homes, Inc
• Deepika Wali, M.D., Inc.
• Carlos-Miguel Del Portillo, CRNA
• Israel Delgado

• All providers in Porterville, CA
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2010; 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.