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General NPI Number Information
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NPI Number | 1487613147
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Entity Type | Organization
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Legal Business Name | FMM HOME CARE CORPORATION
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Dates
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Enumeration Date | 03/21/2006
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Last Update Date | 06/16/2025
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Provider Practice Location Address
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Address Line | 4649 BROCKTON AVE
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City | RIVERSIDE
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State | CA
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Zip | 92506-0131
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Country | US
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Telephone | 951-924-7751
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Fax | 951-924-9042
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Provider Business Mailing Address
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Address Line | 4649 BROCKTON AVE
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City | RIVERSIDE
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State | CA
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Zip | 92506-0131
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Country | US
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Telephone | 951-924-7751
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Fax | 951-924-9042
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | MS. DOLORES DIZON
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Credential |
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Telephone | 951-924-7751
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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 | 250000608
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License Number State | CA
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