Provider Demographics
NPI:1366795577
Name:RIMROCK RESIDENTIAL CARE HOME, INC.
Entity type:Organization
Organization Name:RIMROCK RESIDENTIAL CARE HOME, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ABRAHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ABIRAFEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-844-2277
Mailing Address - Street 1:20115 RIMROCK RD
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92307-2962
Mailing Address - Country:US
Mailing Address - Phone:760-242-7340
Mailing Address - Fax:760-242-7340
Practice Address - Street 1:20115 RIMROCK RD
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92307-2962
Practice Address - Country:US
Practice Address - Phone:760-242-7340
Practice Address - Fax:760-242-7340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-25
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA366407908310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility