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General NPI Number Information
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NPI Number | 1487976577
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Entity Type | Organization
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Legal Business Name | HOLY HILL HOME CARE EAST
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Dates
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Enumeration Date | 02/17/2010
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 34034 NEBRASKA LN
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City | YUCAIPA
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State | CA
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Zip | 92399-2334
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Country | US
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Telephone | 909-446-1148
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Fax | 909-363-8237
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Provider Business Mailing Address
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Address Line | 34034 NEBRASKA LN
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City | YUCAIPA
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State | CA
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Zip | 92399-2334
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Country | US
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Telephone | 909-446-1148
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Fax | 909-363-8237
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Authorized Official
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Title or Position | BUSINESS ADMINISTRATOR
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Name | NICK PURACI
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Credential |
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Telephone | 909-806-9797
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311Z00000X
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Taxonomy Name | Custodial Care Facility
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License Number |
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License Number State | CA
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