# MY HOME INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770620734
- **Authorized official:** MS. HORTENSIA MARIE SANDOVAL (BOOKKEEPER)
- **Authorized official phone:** (707) 527-5744

## Contact information

- **Practice address:** 1639 MANZANITA AVENUE, SANTA ROSA, CA 95404
- **Practice address phone:** (707) 539-7435
- **Practice address fax:** (707) 539-7435
- **Mailing address:** 1983 MT OLIVE DR, SANTA ROSA, CA 95404
- **Mailing address phone:** (707) 527-5744
- **Mailing address fax:** (707) 527-5744

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 01/31/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | LTC60758F | — | CA |