17Th St. House

LBN: Rockcreek, Inc.
17Th St. House is an health care organization with primary practice located at 2312 E 17Th St , San Bernardino CA 92404-6102. 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. Rockcreek, Inc. can be contacted via phone (714) 537-3252, or through Ombres, Deena via phone (502) 394-2387.

Contact Information

Primary practice address
2312 E 17Th St San Bernardino CA 92404-6102
Phone: (714) 537-3252
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Ombres, Deena
Phone: (502) 394-2387

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded 315P00000X

Profile Details

NPI number 1942337217
LBN Legal business name Rockcreek, Inc.
DBA Doing business as 17Th St. House
Authorized official Ombres, Deena
Entity Organization
Organization subpart 1 No
Enumeration date Feb 27th, 2007
Last updated Jul 18th, 2008 - about 16 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1942337217 NPPES
California MEDICAID LTC60379F

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