Healthcare Provider Details

I. General information

NPI: 1013158377
Provider Name (Legal Business Name): GREENHILLS CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2009
Last Update Date: 03/13/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12960 CENTRAL AVENUE SUITE E
CHINO CA
91710
US

IV. Provider business mailing address

12960 CENTRAL AVENUE SUITE E
CHINO CA
91710
US

V. Phone/Fax

Practice location:
  • Phone: 909-591-2777
  • Fax: 909-591-2775
Mailing address:
  • Phone: 909-591-2777
  • Fax: 909-591-2775

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: MARILOU HIPOLITO ANDRES
Title or Position: PRESIDENT
Credential:
Phone: 909-591-2777