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General NPI Number Information
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NPI Number | 1295258564
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Entity Type | Organization
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Legal Business Name | CHINO CARE INC.
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Dates
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Enumeration Date | 07/19/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 5402 PHILADELPHIA ST. SUITE C
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City | CHINO
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State | CA
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Zip | 91765
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Country | US
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Telephone | 909-517-0087
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Fax | 909-517-0078
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Provider Business Mailing Address
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Address Line | 5402 PHILADELPHIA ST STE C
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City | CHINO
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State | CA
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Zip | 91710-2489
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Country | US
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Telephone | 909-517-0087
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Fax | 909-517-0078
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | ANTHONY LO
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Credential |
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Telephone | 909-517-0087
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number | 550003893
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License Number State | CA
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