Healthcare Provider Details

I. General information

NPI: 1447596010
Provider Name (Legal Business Name): WRIGHTS NON MEDICAL HOME CARE PROVIDER SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2012
Last Update Date: 12/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1040 S MOUNT VERNON AVE # G-196
COLTON CA
92324-4228
US

IV. Provider business mailing address

1040 S MOUNT VERNON AVE # G-196
COLTON CA
92324-4228
US

V. Phone/Fax

Practice location:
  • Phone: 404-200-1372
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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 Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code311Z00000X
TaxonomyCustodial Care Facility
License Number
License Number State

VIII. Authorized Official

Name: HERBERT WRIGHT
Title or Position: PRESIDENT
Credential:
Phone: 404-200-1372