Provider Demographics
NPI:1679383053
Name:ATHERTON HOME CORP.
Entity type:Organization
Organization Name:ATHERTON HOME CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MALLARI PADERNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-580-1914
Mailing Address - Street 1:94 ATHERTON CIR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:94565-4708
Mailing Address - Country:US
Mailing Address - Phone:925-427-0877
Mailing Address - Fax:
Practice Address - Street 1:94 ATHERTON CIR
Practice Address - Street 2:
Practice Address - City:PITTSBURG
Practice Address - State:CA
Practice Address - Zip Code:94565-4708
Practice Address - Country:US
Practice Address - Phone:925-427-0877
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-08
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities