1134882970 NPI number — INLAND TEMPORARY HOMES

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 1134882970 NPI number — INLAND TEMPORARY HOMES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
INLAND TEMPORARY HOMES
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:
1134882970
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/19/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 239
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOMA LINDA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92354-0239
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
909-796-6381
Provider Business Mailing Address Fax Number:
909-736-3541

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
25964 MISSION RD.
Provider Second Line Business Practice Location Address:
HERITAGE PARK
Provider Business Practice Location Address City Name:
LOMA LINDA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92354
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
909-736-3539
Provider Business Practice Location Address Fax Number:
909-736-3541
Provider Enumeration Date:
10/19/2021

Additional Information

Authorized Official

Authorized Official Last Name:
LITTLE
Authorized Official First Name:
JEFF
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
909-796-6381

Provider Taxonomy Codes

  • Taxonomy code: 251X00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com