1508435769 NPI number — BETTER HEALTH HOME HEALTHCARE, 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 1508435769 NPI number — BETTER HEALTH HOME HEALTHCARE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BETTER HEALTH HOME HEALTHCARE, 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:
1508435769
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/22/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1264 S WATERMAN AVE STE 51
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN BERNARDINO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92408-2851
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
707-377-0004
Provider Business Mailing Address Fax Number:
707-377-0005

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1264 S WATERMAN AVE STE 51
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN BERNARDINO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92408-2851
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
707-377-0004
Provider Business Practice Location Address Fax Number:
707-377-0005
Provider Enumeration Date:
06/22/2021

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
GHUKASIAN
Authorized Official First Name:
MARYAM
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER, CEO, CFO, SECRETARY
Authorized Official Telephone Number:
707-377-0004

Provider Taxonomy Codes

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

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