Klamath Home Icf Ddn
LBN: Antelope Hills Manor Icf Ddn Inc
Klamath Home Icf Ddn is an health care organization with primary practice located at 7704 Antelope Hills Dr , Antelope CA 95843-2491. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded, which is considered as the primary health care specialty.
Antelope Hills Manor Icf Ddn Inc can be contacted via phone (916) 721-1517, or through Ranit, Antonio Gagante via phone (916) 721-9439.
Contact Information
Primary practice address
7704 Antelope Hills Dr
Antelope CA 95843-2491
Phone: (916) 721-1517
Fax: (916) 721-0762
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded | 315P00000X |
Profile Details
| NPI number | 1770622292 |
|---|---|
| LBN Legal business name | Antelope Hills Manor Icf Ddn Inc |
| DBA Doing business as | Klamath Home Icf Ddn |
| Authorized official | Ranit, Antonio Gagante REGISTERED NURSE |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Feb 5th, 2007 |
| Last updated | Aug 22nd, 2020 - about 4 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1770622292 | NPPES |
| California | MEDICAID | LTC80373F | |
| California | MEDICAID | LTC80334F |
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