Organization · Type 2 NPI

Angel 1004 Residential Home

Assisted Living Facility · Fontana, CA

NPI number 1609719764 Active

Practice location

7142 Verdugo Pl
Fontana, CA 92336-1452

Call (909) 855-3105 Map

Specialties and licenses

TaxonomyCodeLicense
Assisted Living Facility Primary 310400000XNone listed

Assisted Living Facility: A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

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About NPI 1609719764

Angel 1004 Residential Home's National Provider Identifier is 1609719764, issued on Apr 13, 2026. The primary taxonomy on file is Assisted Living Facility (310400000X), and the practice location is in Fontana, CA. The record was last updated on Apr 13, 2026.