OSTERMAN'S #3 INC


Address: 4741 Pensacola St, Shasta Lake, CA 96019-9773
Phone: 5302752346

OSTERMAN'S #3 INC (NPI# 1548452808) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1548452808
Entity Type Organization
Organization Name OSTERMAN'S #3 INC
Practice Address 4741 Pensacola St
Shasta Lake
CA 96019-9773
Mailing Address Po Box 905
Shasta Lake
CA 96019-0905
Practice Telephone 5302752346
Practice Fax Number 5302756674
Mailing Telephone 5302752346
Mailing Fax Number 5302756674
Enumeration Date 2007-08-10
Last Update Date 2007-08-10
Authorized Official Name MRS. DORIS SUSAN OSTERMAN (OWNER ADMINISTRATOR)
Authorized Official Telephone 5302752346
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 320900000X Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities CA Residential Treatment Facilities

Other Provider Identifier

State Issuer Identifier Type Code
CA MEDI-CAL LTC 60729G 01

Office Location

Street Address 4741 PENSACOLA ST
City SHASTA LAKE
State CA
Zip Code 96019-9773

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Taxonomy Information

Taxonomy Code 320900000X
Grouping Residential Treatment Facilities
Classification Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities

Taxonomy Definition

A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.
Notes: [7/1/2003: new]

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1790126423 Contemporary Behavior Consultants, Inc Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 8032 E Bynum St, Long Beach, CA 90808-3231 2013-07-10
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Competitor

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City SHASTA LAKE
Zip Code 96019

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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