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Organization
DEBOER HOME #2
Active
Organization
DEBOER HOME #2
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BREANN DEBOER (LICENSEE)
(559) 350-3695
Entity
Organization
Contact information
Practice address
2211 W ORANGE AVE, PORTERVILLE, CA 93257-7305
(559) 350-3695
(559) 793-2718
Mailing address
2211 W ORANGE AVENUE, PORTERVILLE, CA 93257-7000
(559) 350-3695
(559) 793-2718
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
550001291
CA
Other
Enumeration date
08/27/2010
Last updated
08/27/2010
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