Provider Demographics
NPI:1154642809
Name:CIVILLANI D. LAYOS
Entity Type:Organization
Organization Name:CIVILLANI D. LAYOS
Other - Org Name:3 R'S HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CIVILLANI
Authorized Official - Middle Name:DELA PENA
Authorized Official - Last Name:LAYOS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:909-574-6192
Mailing Address - Street 1:15362 GARFIELD DRIVE
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92336
Mailing Address - Country:US
Mailing Address - Phone:909-574-6192
Mailing Address - Fax:909-574-6192
Practice Address - Street 1:15362 GARFIELD DRIVE
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92336
Practice Address - Country:US
Practice Address - Phone:909-574-6192
Practice Address - Fax:909-574-6192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-17
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28911251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health