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General NPI Number Information
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NPI Number | 1326117250
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Entity Type | Organization
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Legal Business Name | DOUBLE ACE HOME HEALTH SERVICES, INC.
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Dates
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Enumeration Date | 11/07/2006
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Last Update Date | 01/06/2012
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Provider Practice Location Address
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Address Line | 8459 WHITE OAK AVE #104
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-3872
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Country | US
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Telephone | 909-476-9922
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Fax | 909-476-0033
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Provider Business Mailing Address
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Address Line | 8459 WHITE OAK AVE SUITE 104
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-3872
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Country | US
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Telephone | 909-476-9922
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Fax | 909-476-0033
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. RICHARD MIYAKE
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Credential |
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Telephone | 909-476-9922
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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 | 240000879
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License Number State | CA
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