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General NPI Number Information
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NPI Number | 1992152151
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Entity Type | Organization
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Legal Business Name | CJ FRONTLINE, LLC
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Dates
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Enumeration Date | 05/18/2016
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Last Update Date | 05/18/2016
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Provider Practice Location Address
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Address Line | 101 LUCAS VALLEY RD SUITE 236
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City | SAN RAFAEL
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State | CA
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Zip | 94903-1791
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Country | US
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Telephone | 415-521-6847
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Fax | 415-729-1691
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Provider Business Mailing Address
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Address Line | PO BOX 6029
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City | SAN RAFAEL
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State | CA
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Zip | 94903-0029
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Country | US
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Telephone | 415-521-6847
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Fax | 415-729-1691
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | CHLOE YUK TING HEUNG
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Credential |
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Telephone | 415-521-6847
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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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