Provider Demographics
NPI:1992028740
Name:THERAPEUTIC RESIDENTIAL SERVICES, INC
Entity type:Organization
Organization Name:THERAPEUTIC RESIDENTIAL SERVICES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HARMESH
Authorized Official - Middle Name:
Authorized Official - Last Name:KUMAR
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:925-285-9881
Mailing Address - Street 1:2249 PACHECO ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-2015
Mailing Address - Country:US
Mailing Address - Phone:925-356-0122
Mailing Address - Fax:925-356-0124
Practice Address - Street 1:175 W SIERRA AVE
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93612-0283
Practice Address - Country:US
Practice Address - Phone:559-299-5579
Practice Address - Fax:559-299-2542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-08
Last Update Date:2010-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA107203505310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility