Organization
KHT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES LACUESTA SANTIAGO (ADMINISTRATOR)
(562) 469-9005
Entity
Organization
Contact information
Practice address
2044 HOLLY AVE, ONTARIO, CA 91762-6322
(562) 469-9005
Mailing address
2044 HOLLY AVE, ONTARIO, CA 91762-6322
(562) 469-9005
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
02/03/2021
Last updated
02/03/2021
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