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General NPI Number Information
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NPI Number | 1003199357
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Entity Type | Organization
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Legal Business Name | FOUNDING FATHERS HEALTH CARE, INC.
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Dates
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Enumeration Date | 09/23/2011
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Last Update Date | 02/09/2021
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Provider Practice Location Address
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Address Line | 1307 W 6TH ST STE 201
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City | CORONA
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State | CA
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Zip | 92882-1644
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Country | US
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Telephone | 800-792-9434
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Fax | 800-401-6980
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Provider Business Mailing Address
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Address Line | 1307 W 6TH ST STE 201
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City | CORONA
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State | CA
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Zip | 92882-1644
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Country | US
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Telephone | 800-792-9434
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Fax | 800-401-6980
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Authorized Official
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Title or Position | ADMINISTRATOR/CEO
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Name | MR. BRYAN LANGLEY
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Credential |
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Telephone | 951-808-7215
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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