Healthcare Provider Details

I. General information

NPI: 1043047426
Provider Name (Legal Business Name): ADVANCE HEIGHTS HOME HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2024
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4097 TRAIL CREEK ROAD SUITE 105
RIVERSIDE CA
92505
US

IV. Provider business mailing address

14465 SALINE DR
EASTVALE CA
92880-3770
US

V. Phone/Fax

Practice location:
  • Phone: 951-801-0549
  • Fax: 310-870-9266
Mailing address:
  • Phone: 951-801-0549
  • Fax: 310-870-9266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: NNEKA NWANI
Title or Position: EXECUTIVE CEO
Credential: APRN PMHNP-BC
Phone: 951-801-0549