Healthcare Provider Details

I. General information

NPI: 1215640958
Provider Name (Legal Business Name): CLICK MED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2022
Last Update Date: 12/27/2022
Certification Date: 12/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

78120 SUIT 206
LA QUINTA CA
92253-0141
US

IV. Provider business mailing address

PO BOX 425
REDLANDS CA
92373-0141
US

V. Phone/Fax

Practice location:
  • Phone: 833-236-2369
  • Fax:
Mailing address:
  • Phone: 833-236-2369
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. LEIDIANA DAVILA
Title or Position: PRESIDENT
Credential: C.E.O
Phone: 760-969-3471