Organization
PREFERRED HOME HEALTH PROVIDER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CARIE LIMOS DUPRE (ADMINISTRATOR)
(909) 980-9518
Entity
Organization
Contact information
Practice address
8560 VINEYARD AVE, RANCHO CUCAMONGA, CA 91730-4349
(909) 980-9518
(909) 980-9521
Mailing address
8560 VINEYARD AVE, SUITE 505, RANCHO CUCAMONGA, CA 91730-4349
(909) 980-9518
(909) 980-9521
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
550000194
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
550000194
DHS LICENSE NUMBER
CA
Enumeration date
04/25/2007
Last updated
06/13/2012
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