Healthcare Provider Details

I. General information

NPI: 1982940094
Provider Name (Legal Business Name): LITTLE HELPER HOMECARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2012
Last Update Date: 02/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27180 NEWPORT RD
MENIFEE CA
92584-7385
US

IV. Provider business mailing address

PO BOX 235
WILDOMAR CA
92595-0235
US

V. Phone/Fax

Practice location:
  • Phone: 888-536-1116
  • 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

VIII. Authorized Official

Name: MRS. NIQUITA NIKKOLE CLUGSTON
Title or Position: FOUNDER/ NURSE DIRECTOR
Credential:
Phone: 888-536-1116