Provider Demographics
NPI:1003528001
Name:LIJALE HOME HEALTH
Entity Type:Organization
Organization Name:LIJALE HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LILIBETH
Authorized Official - Middle Name:
Authorized Official - Last Name:GUZMAN ROMERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-291-5205
Mailing Address - Street 1:9161 LOCUST AVE
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92335-6074
Mailing Address - Country:US
Mailing Address - Phone:909-291-5205
Mailing Address - Fax:
Practice Address - Street 1:9161 LOCUST AVE
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92335-6074
Practice Address - Country:US
Practice Address - Phone:909-291-5205
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-21
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health