Provider Demographics
NPI:1285029140
Name:HEALTH TO HOME, INC
Entity Type:Organization
Organization Name:HEALTH TO HOME, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY/TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:STANLEY
Authorized Official - Last Name:WILDISH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-368-0428
Mailing Address - Street 1:5750 DIVISION ST STE 209
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-3269
Mailing Address - Country:US
Mailing Address - Phone:951-368-0428
Mailing Address - Fax:951-368-0429
Practice Address - Street 1:5750 DIVISION ST
Practice Address - Street 2:SUITE 209
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-3269
Practice Address - Country:US
Practice Address - Phone:951-368-0428
Practice Address - Fax:951-368-0429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-30
Last Update Date:2015-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA65963207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Multi-Specialty