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Organization
PEACOCK DESERT ROSE SERVICES LIMITED
Active
Organization
PEACOCK DESERT ROSE SERVICES LIMITED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAI HARPER (PRESIDENT)
(909) 689-6095
Entity
Organization
Contact information
Practice address
967 KENDALL DR # A329, SAN BERNARDINO, CA 92407-4306
(909) 689-6095
Mailing address
967 KENDALL DR # A329, SAN BERNARDINO, CA 92407-4306
(909) 689-6095
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
—
—
251B00000X
Case Management Agency
—
—
251J00000X
Nursing Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
11/29/2020
Last updated
11/29/2020
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