Healthcare Provider Details

I. General information

NPI: 1245533843
Provider Name (Legal Business Name): ANGELS IN MOTION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2010
Last Update Date: 12/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4091 RIVERSIDE DR SUITE 210
CHINO CA
91710-6501
US

IV. Provider business mailing address

4091 RIVERSIDE DR SUITE 210
CHINO CA
91710-6501
US

V. Phone/Fax

Practice location:
  • Phone: 909-590-9102
  • Fax: 909-590-9239
Mailing address:
  • Phone: 909-590-9102
  • Fax: 909-590-9239

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. DOMINIQUE ALVAREZ
Title or Position: DIRECTOR
Credential:
Phone: 909-590-9102