Healthcare Provider Details

I. General information

NPI: 1578114674
Provider Name (Legal Business Name): HOME PERSONAL AIDE REFERRAL REGISTRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2019
Last Update Date: 09/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12189 7TH ST STE 108
YUCAIPA CA
92399-2233
US

IV. Provider business mailing address

12189 7TH ST STE 108
YUCAIPA CA
92399-2233
US

V. Phone/Fax

Practice location:
  • Phone: 951-536-3318
  • Fax:
Mailing address:
  • Phone: 951-536-3318
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QE0002X
TaxonomyEmergency Care Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: ROBERT ALANIS
Title or Position: OPERATIONS DIRECTOR
Credential:
Phone: 951-536-3318