Provider Demographics
NPI:1093798977
Name:ETHICAL HOME HEALTH CARE INC
Entity Type:Organization
Organization Name:ETHICAL HOME HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:FERNANDO
Authorized Official - Middle Name:
Authorized Official - Last Name:FLORES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-946-9000
Mailing Address - Street 1:550 N EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-4734
Mailing Address - Country:US
Mailing Address - Phone:909-946-9000
Mailing Address - Fax:909-981-0400
Practice Address - Street 1:550 N EUCLID AVE
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-4734
Practice Address - Country:US
Practice Address - Phone:909-946-9000
Practice Address - Fax:909-981-0400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-23
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA240000670251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA05-8026OtherMEDICARE PROVIDER
CA240000670OtherHHA LICENSE
CAHHA08026GMedicaid
CA406364346OtherOSHPD ID
240001549OtherACLAIMS #