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General NPI Number Information
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NPI Number | 1356844096
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Entity Type | Organization
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Legal Business Name | ST. FRANCIS HOME HEALTH AGENCY, INC.
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Dates
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Enumeration Date | 03/08/2018
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Last Update Date | 02/07/2020
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Provider Practice Location Address
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Address Line | 10970 ARROW RTE STE 205
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-4839
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Country | US
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Telephone | 909-989-7700
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Fax | 909-457-6353
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Provider Business Mailing Address
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Address Line | 10970 ARROW RTE STE 206
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-4839
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Country | US
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Telephone | 909-989-5383
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Fax | 909-457-6353
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MARTIN AIYETIWA
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Credential |
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Telephone | 909-989-7700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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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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