Organization
BASIC LIVING HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CALLISTUS E AMAJOYI (OWNER/PRESIDENT)
(909) 334-7172
Entity
Organization
Contact information
Practice address
222 E MAIN ST STE 216, BARSTOW, CA 92311-2366
(909) 334-7172
Mailing address
222 E MAIN ST STE 216, BARSTOW, CA 92311-2366
(909) 334-7172
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
11/16/2020
Last updated
11/25/2020
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