Tyler Residential Care Inc.

Primary specialty

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

License

306000575 Issued in CA

Legal business name

TYLER RESIDENTIAL CARE INC.

Practice address

6052 Western Ave
Buena Park, CA 90621-2325

Phone

(714) 521-0140

NPI assigned

Nov 9, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Benjamin Tolentino Penalosa, ADMINISTRATOR

Title

President

Phone

(714) 394-7652

Specialties & licenses 1

Addresses

Other names 1

• None Other name

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

{
    "created_epoch": "1320796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320796800000",
    "number": "1831476589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 N GUADALUPE AVE",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902772952",
            "telephone_number": "714-394-7652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6052 WESTERN AVE",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906212325",
            "telephone_number": "714-521-0140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TYLER RESIDENTIAL CARE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-09",
        "last_updated": "2011-11-09",
        "status": "A",
        "authorized_official_last_name": "PENALOSA",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "TOLENTINO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-394-7652",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ADMINISTRATOR"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "CA",
            "license": "306000575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "None",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Buena Park, CA
• Providers in Buena Park, CA by specialty
• 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 Nov 9, 2011; 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.