Organization
CHENEY HOME ICF-DD/N II
Active
Parent organization
CHENEY HOME ICF-DD/N
Other names
CHENEY HOME ICF-DD/N
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHENEY HOME ICF-DD/N
Authorized official
RITA I REGINALDO-ROXAS (RN/ADMINISTRATOR)
(510) 861-2635
Entity
Organization
Contact information
Practice address
2166 BOCA RATON ST, HAYWARD, CA 94545-3534
(510) 293-0360
(510) 293-0365
Mailing address
1755 CANTERBURY LN, HAYWARD, CA 94544-8710
(510) 861-2635
(510) 293-0365
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
550002962
CA
Other
Enumeration date
09/10/2015
Last updated
09/10/2015
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