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General NPI Number Information
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NPI Number | 1073871570
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Entity Type | Organization
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Legal Business Name | GHC HOME HEALTH, INC.
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Dates
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Enumeration Date | 05/03/2012
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Last Update Date | 12/26/2012
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Provider Practice Location Address
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Address Line | 350 W 5TH ST STE #103
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City | SAN BERNARDINO
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State | CA
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Zip | 92401-1351
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Country | US
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Telephone | 951-545-4462
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Fax | 909-981-9652
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Provider Business Mailing Address
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Address Line | 1476 W 9TH ST STE # B-1
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City | UPLAND
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State | CA
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Zip | 91786-5743
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Country | US
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Telephone | 951-545-4462
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Fax | 909-981-9652
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | KATHLEEN JANET HAYWOOD
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Credential |
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Telephone | 951-545-4462
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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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