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General NPI Number Information
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NPI Number | 1831870393
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Entity Type | Organization
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Legal Business Name | INFINITE BLESSINGS CARE HOME INC.
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Dates
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Enumeration Date | 07/27/2023
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Last Update Date | 07/27/2023
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Provider Practice Location Address
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Address Line | 23711 PROSPECT VALLEY DR
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City | DIAMOND BAR
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State | CA
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Zip | 91765-1637
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Country | US
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Telephone | 909-895-7262
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Fax | 909-895-7262
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Provider Business Mailing Address
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Address Line | 732 VIEW LN
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City | DIAMOND BAR
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State | CA
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Zip | 91765-1896
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Country | US
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Telephone | 909-714-4373
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JAIME DURAN
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Credential |
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Telephone | 909-714-4373
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 315P00000X
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Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
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License Number |
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License Number State |
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