Organization
LAMB'S LIGHT HOME HEALTH SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY KIILU RN (ADMINISTRATOR)
(909) 581-0900
Entity
Organization
Contact information
Practice address
9045 HAVEN AVE STE 100, RANCHO CUCAMONGA, CA 91730-5427
(909) 581-0900
(909) 581-1833
Mailing address
9045 HAVEN AVE STE 100, RANCHO CUCAMONGA, CA 91730-5427
(909) 581-0900
(909) 581-1833
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
037880
BUSINESS LICENSE NO.
CA
05
—
HHA08147F
—
CA
01
—
HJ0270-854
IRC VENDOR NO.
CA
Enumeration date
07/09/2006
Last updated
11/30/2007
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