Organization
HEMMA, INC
Active
Other names
Mountain Home
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD AARON CARLSON (CEO)
(949) 648-9395
Entity
Organization
Contact information
Practice address
1922 N MOUNTAIN AVE, CLAREMONT, CA 91711-2605
(909) 624-2437
Mailing address
PO BOX 6086, IRVINE, CA 92616-6086
(949) 648-9395
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
960000857
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LTC60589F
PROVIDER NUMBER
CA
Enumeration date
05/15/2007
Last updated
04/23/2008
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