1407077126 NPI number — HOLY INFANT HOME CARE, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407077126 NPI number — HOLY INFANT HOME CARE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOLY INFANT HOME CARE, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1407077126
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
791 MARYLIND AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLAREMONT
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91711-3531
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
909-603-9312
Provider Business Mailing Address Fax Number:
909-399-3272

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
791 MARYLIND AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLAREMONT
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91711-3531
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
909-603-9312
Provider Business Practice Location Address Fax Number:
909-399-3272
Provider Enumeration Date:
05/01/2007

Additional Information

Authorized Official

Authorized Official Last Name:
OCHOCO
Authorized Official First Name:
ARTURO
Authorized Official Middle Name:
CAPARAS
Authorized Official Title or Position:
CHIEF FINANCIAL OFFICER
Authorized Official Telephone Number:
909-603-9312

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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