Provider Demographics
NPI:1083796973
Name:ALLIED PROFESSIONAL NURSING CARE, INC
Entity Type:Organization
Organization Name:ALLIED PROFESSIONAL NURSING CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONETTE
Authorized Official - Middle Name:CHARISSE
Authorized Official - Last Name:LUMBSDEN
Authorized Official - Suffix:
Authorized Official - Credentials:RNP
Authorized Official - Phone:909-949-1066
Mailing Address - Street 1:2345 W FOOTHILL BLVD STE 14
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-3579
Mailing Address - Country:US
Mailing Address - Phone:909-949-1066
Mailing Address - Fax:909-949-1655
Practice Address - Street 1:2345 W FOOTHILL BLVD STE 14
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-3579
Practice Address - Country:US
Practice Address - Phone:909-949-1066
Practice Address - Fax:909-949-1655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHHA70282GMedicaid
CAHHA70282FMedicaid