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General NPI Number Information
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NPI Number | 1912529074
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Entity Type | Organization
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Legal Business Name | HIGH DESERT COMMUNITY HOME HEALTH INC
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Dates
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Enumeration Date | 05/12/2020
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Last Update Date | 05/12/2020
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Provider Practice Location Address
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Address Line | 222 E MAIN ST STE 216
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City | BARSTOW
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State | CA
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Zip | 92311-2366
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Country | US
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Telephone | 909-582-0515
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Fax |
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Provider Business Mailing Address
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Address Line | 5050 JUNEAU CT
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91739-2653
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Country | US
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Telephone | 909-961-9379
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CELESTINE AMAJOYI
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Credential |
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Telephone | 909-961-9379
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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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