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Organization
CBL
Active
Organization
CBL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARMAINE BURNETT (PRESIDENT)
(909) 484-0933
Entity
Organization
Contact information
Practice address
9057 ARROW RTE, SUITE 180, RANCHO CUCAMONGA, CA 91730-4452
(909) 484-0933
(909) 484-0939
Mailing address
9057 ARROW RTE, SUITE 180, RANCHO CUCAMONGA, CA 91730-4452
(909) 484-0933
(909) 484-0939
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
NULL
Other
Enumeration date
09/03/2014
Last updated
09/03/2014
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