Provider Demographics
NPI:1073871570
Name:GHC HOME HEALTH, INC.
Entity Type:Organization
Organization Name:GHC HOME HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:JANET
Authorized Official - Last Name:HAYWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-545-4462
Mailing Address - Street 1:1476 W 9TH ST
Mailing Address - Street 2:STE # B-1
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-5743
Mailing Address - Country:US
Mailing Address - Phone:951-545-4462
Mailing Address - Fax:909-981-9652
Practice Address - Street 1:350 W 5TH ST
Practice Address - Street 2:STE #103
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92401-1351
Practice Address - Country:US
Practice Address - Phone:951-545-4462
Practice Address - Fax:909-981-9652
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-03
Last Update Date:2012-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health