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General NPI Number Information
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NPI Number | 1346537966
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Entity Type | Organization
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Legal Business Name | PRO-HEALTH PATIENT CARE NETWORK, LLC
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Dates
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Enumeration Date | 07/03/2011
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Last Update Date | 07/03/2011
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Provider Practice Location Address
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Address Line | 1142 S DIAMOND BAR BLVD #796
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City | DIAMOND BAR
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State | CA
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Zip | 91765-2203
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Country | US
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Telephone | 888-666-9338
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Fax |
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Provider Business Mailing Address
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Address Line | 13768 ROSWELL AVE #209
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City | CHINO
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State | CA
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Zip | 91710-1401
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Country | US
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Telephone | 888-666-9338
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. JOYCE K THOMAS
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Credential | MHA
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Telephone | 888-666-9338
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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 | CA
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