1073871570 NPI number — GHC HOME HEALTH, INC.

Table of content: (NPI 1073871570)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073871570 NPI number — GHC HOME HEALTH, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GHC HOME HEALTH, 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:
1073871570
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/26/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1476 W 9TH ST
Provider Second Line Business Mailing Address:
STE # B-1
Provider Business Mailing Address City Name:
UPLAND
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91786-5743
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
951-545-4462
Provider Business Mailing Address Fax Number:
909-981-9652

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
350 W 5TH ST
Provider Second Line Business Practice Location Address:
STE #103
Provider Business Practice Location Address City Name:
SAN BERNARDINO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92401-1351
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
951-545-4462
Provider Business Practice Location Address Fax Number:
909-981-9652
Provider Enumeration Date:
05/03/2012

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HAYWOOD
Authorized Official First Name:
KATHLEEN
Authorized Official Middle Name:
JANET
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
951-545-4462

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)