SGCC-HOMEREST HOME
NPI 1205384559
Residential Treatment Facility, Emotionally Disturbed Children in Azusa, CA
- Organization
- Residential Treatment Facility, Emotiona...
About SGCC-HOMEREST HOME
This page provides the complete NPI Profile along with additional information for Sgcc-homerest Home, a provider established in Azusa, California operating as a Residential Treatment Facility, Emotionally Disturbed Children. The healthcare provider is registered in the NPI registry with number 1205384559 assigned on September 2016. The practitioner's primary taxonomy code is 322D00000X. The provider is registered as an organization and their NPI record was last updated 2 years ago. The provider's other name is Sgcc-homerest Home. The authorized official of this NPI record is Mr. Porfirio Rincon (Ceo)
- NPI
- 1205384559 Verify this NPI
- Provider Legal Name
- SAN GABRIEL CHILDRENS CENTER INC.
- Other Organization Name
- SGCC-HOMEREST HOME
- Other Name Type
- Other Name (5)
- Entity Type
- Organization
- Location Address
- 5329 N HOMEREST AVE AZUSA, CA 91702
- Location Phone
- (626) 859-2089
- Location Fax
- (626) 859-6537
- Mailing Address
- 1211 CENTER COURT DR STE 105 COVINA, CA 91724
- Mailing Phone
- (626) 859-2089
- Mailing Fax
- (626) 859-6537
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 09-15-2016
- Last Update Date
- 05-01-2024
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Residential Treatment Facility, Emotionally Disturbed Children
- Taxonomy Code
- 322D00000X
- Type
- Residential Treatment Facilities
- Taxonomy Description
- A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 0000056BJ | MEDICAID (05) | CA |
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Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
AZUSA, CA 91702
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1205384559, enumerated as an "organization" on September 15, 2016.
The provider is located at 5329 N HOMEREST AVE AZUSA, CA 91702 and the phone number is (626) 859-2089.
Residential Treatment Facility, Emotionally Disturbed Children with taxonomy code 322D00000X.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
