Organization
GENUS HOME CARE OF SAN BERNARDINO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANET HAYWOOD (ADMINISTRATOR)
(909) 386-1821
Entity
Organization
Contact information
Practice address
515 N MOUNTAIN VIEW AVE, SAN BERNARDINO, CA 92401-1207
(909) 386-1821
(909) 386-1822
Mailing address
350 W 5TH ST STE 212, SAN BERNARDINO, CA 92401-1313
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
059014
MEDICARE PTAN
CA
Enumeration date
12/20/2006
Last updated
08/05/2020
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