Healthcare Provider Details

I. General information

NPI: 1598734626
Provider Name (Legal Business Name): ST. ANTHONY'S HOME CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22365 BARTON ROAD SUITE 212
GRAND TERRACE CA
92313-5071
US

IV. Provider business mailing address

22365 BARTON ROAD SUITE 212
GRAND TERRACE CA
92313-5071
US

V. Phone/Fax

Practice location:
  • Phone: 909-885-5357
  • Fax:
Mailing address:
  • Phone: 909-885-5357
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MS. LYDIA SANTAMARIA
Title or Position: CEO
Credential: MBA
Phone: 909-885-5357