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PACIFIC HOME CA
NPI 1164663746
Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Carson, CA

Active since March 12, 2009CLIA 05D1019730 · Waiver
254 E 220TH ST, CARSON, CA 90745(310) 518-5178(310) 518-5005 Get Directions Write a Review

NPPES record last updated: March 12, 2009. Verified against the NPPES registry weekly; last sync: September 06, 2026.

About Pacific Home Ca NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PACIFIC HOME CA (NPI 1164663746) is a healthcare organization registered as a residential treatment facility, intellectual and/or developmental disabilities in Carson, California and active in the NPI registry since March 2009. The organization holds a CLIA Waiver certificate valid through July 27, 2028 and lists Rosaline B Tanglao, Owner/licensee, as its authorized official.

NPPES Registry Identity

NPI1164663746
Entity TypeOrganization
Primary Taxonomy320600000X
Legal Business NamePACIFIC HOME CA
Location Address254 E 220TH STCarson, CA 90745-3012
Mailing Address254 E 220th StCarson, CA 90745-3012 · (310) 518-5178 · Fax (310) 518-5005
Phone(310) 518-5178
Fax(310) 518-5005
Organization SubpartNo
Authorized OfficialRosaline B TanglaoOwner/licensee · (310) 518-5178
Enumeration DateMarch 12, 2009
✔ NPI 1164663746 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesResidential Treatment Facilities
Taxonomy Code320600000X
Definition
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.
254 E 220TH ST, Carson, CA 90745
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D1019730

Pacific Home Care · Carson, CA
Active · expires Jul 27, 2028
CLIA Number05D1019730
Laboratory TypeIntermediate Care Facility For Mentally Retarded
Certificate Effective DateJuly 28, 2026
Certificate Expiration DateJuly 27, 2028
Laboratory DirectorVirgilio Panganiban
Laboratory Phone(310) 518-5178
Laboratory LocationPacific Home Care254 East 228th St, Carson, CA 90745
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pacific Home Ca's NPI number?

The NPI number for Pacific Home Ca is 1164663746. It was assigned to this organization in the NPPES registry on March 12, 2009.

Where is Pacific Home Ca located?

Pacific Home Ca is located at 254 E 220th St, Carson, CA 90745. The listed phone number is (310) 518-5178.

What is Pacific Home Ca's specialty?

The primary specialty registered for this NPI is Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320600000X.

Does Pacific Home Ca hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D1019730) is associated with this NPI, valid through July 27, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Pacific Home Ca was last updated on March 12, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.