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General NPI Number Information
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NPI Number | 1255583522
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Entity Type | Organization
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Legal Business Name | HONOR 2 SERVE
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Dates
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Enumeration Date | 10/18/2008
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Last Update Date | 10/18/2008
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Provider Practice Location Address
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Address Line | 310 E SAN BERNARDINO RD SUITE A
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City | COVINA
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State | CA
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Zip | 91723-1641
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Country | US
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Telephone | 626-858-4630
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Fax | 626-858-4787
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Provider Business Mailing Address
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Address Line | 310 E SAN BERNARDINO RD SUITE A
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City | COVINA
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State | CA
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Zip | 91723-1641
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Country | US
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Telephone | 626-858-4630
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Fax | 626-858-4787
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | CHERYCE BENNETT-TAY
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Credential |
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Telephone | 626-858-4630
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 033958
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License Number State | CA
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