Organization
LA HOMECARE PROVIDER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARNEY MARTINEZ RN (VICE PRES/ ADMINISTRATOR)
(909) 599-0777
Entity
Organization
Contact information
Practice address
1117 VIA VERDE, SAN DIMAS, CA 91773-4400
(909) 599-0777
(909) 599-0711
Mailing address
1117 VIA VERDE, SAN DIMAS, CA 91773-4400
(909) 599-0777
(909) 599-0711
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
980001434
CA
Other
Enumeration date
03/22/2006
Last updated
03/21/2012
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