Provider Demographics
NPI:1124340815
Name:CHATEAU BATTISTE AT HEMET STREET
Entity type:Organization
Organization Name:CHATEAU BATTISTE AT HEMET STREET
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:NIKHOL
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-322-9925
Mailing Address - Street 1:255 N EL CIELO RD # 140-195
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-6974
Mailing Address - Country:US
Mailing Address - Phone:760-322-9925
Mailing Address - Fax:760-322-9914
Practice Address - Street 1:161 N HEMET ST
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92544-5037
Practice Address - Country:US
Practice Address - Phone:951-927-6817
Practice Address - Fax:951-927-8439
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMERICAN FORENSIC NURSES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-02-22
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA336412259310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility