Organization
CARE REPUBLIC CCA LLC
Active
Other names
Care Republic CCA LLC
Organization subpart
No
Provider details
NPI number
Authorized official
JEMALYNE PINO BUNO (OWNER)
(909) 317-8207
Entity
Organization
Contact information
Practice address
11175 AZUSA CT STE 110, RANCHO CUCAMONGA, CA 91730-4933
(909) 317-8207
Mailing address
11175 AZUSA CT STE 110, RANCHO CUCAMONGA, CA 91730-4933
(909) 317-8207
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
11/27/2023
Last updated
12/13/2023
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