REALITOS DIVISON
NPI 1912159385
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in La Verne, CA
- Organization
- Community Based Residential Treatment Fa...
About REALITOS DIVISON
This page provides the complete NPI Profile along with additional information for Realitos Divison, a provider established in La Verne, California operating as a Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities. The healthcare provider is registered in the NPI registry with number 1912159385 assigned on October 2008. The practitioner's primary taxonomy code is 320900000X with license number 960000953 (CA). The provider is registered as an organization and their NPI record was last updated one year ago. The authorized official of this NPI record is Miss Deisy Odett Mendoza (Executive Director)
- NPI
- 1912159385 Verify this NPI
- Provider Name
- REALITOS DIVISON
- Entity Type
- Organization
- Location Address
- 612 REALITOS DR LA VERNE, CA 91750
- Location Phone
- (909) 899-5046
- Location Fax
- (909) 463-2005
- Mailing Address
- 13342 VICTORIA ST RANCHO CUCAMONGA, CA 91739
- Mailing Phone
- (909) 899-5046
- Mailing Fax
- (909) 463-2005
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 10-16-2008
- Last Update Date
- 06-18-2025
- 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
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
- Taxonomy Code
- 320900000X
- Type
- Residential Treatment Facilities
- License No.
- 960000953
- License State
- CA
- Taxonomy Description
- A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.
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Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1912159385, enumerated as an "organization" on October 16, 2008.
The provider is located at 612 REALITOS DR LA VERNE, CA 91750 and the phone number is (909) 899-5046.
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320900000X.
