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General NPI Number Information
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NPI Number | 1588961478
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Entity Type | Organization
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Legal Business Name | DAMEKOLA NURSING AGENCY
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Dates
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Enumeration Date | 02/11/2011
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Last Update Date | 02/11/2011
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Provider Practice Location Address
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Address Line | 635 VIEW LN
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City | CORONA
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State | CA
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Zip | 92881-8347
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Country | US
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Telephone | 951-531-8657
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Fax | 951-496-4166
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Provider Business Mailing Address
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Address Line | 635 VIEW LN
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City | CORONA
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State | CA
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Zip | 92881-8347
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Country | US
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Telephone | 951-531-8657
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Fax | 951-496-4166
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. MARGARET BALOGUN
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Credential |
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Telephone | 951-531-8657
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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 |
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