Organization
NAJEH HAMED
Active
Other names
Nick's Maple Home LLC
Organization subpart
No
Provider details
NPI number
Authorized official
NAJEH HAMED (OWNER)
(786) 219-6008
Entity
Organization
Contact information
Practice address
9008 S. MAPLE AVENUE, FONTANA, CA 92335
(786) 219-6008
Mailing address
9008 MAPLE AVE, FONTANA, CA 92335-6038
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
361800144
STATE LICENSE
CA
Enumeration date
10/08/2018
Last updated
10/08/2018
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