Provider Demographics
NPI:1043961469
Name:BLUEBERRY HILL HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:BLUEBERRY HILL HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ERLINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:COLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-484-6122
Mailing Address - Street 1:357 W 2ND ST STE 11C
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92401-1803
Mailing Address - Country:US
Mailing Address - Phone:818-484-6122
Mailing Address - Fax:
Practice Address - Street 1:357 W 2ND ST STE 11C
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92401-1803
Practice Address - Country:US
Practice Address - Phone:818-484-6122
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-18
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health