Provider Demographics
NPI:1316554512
Name:CONNECTA HEALTHCARE SERVICES INC
Entity Type:Organization
Organization Name:CONNECTA HEALTHCARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOING
Authorized Official - Suffix:
Authorized Official - Credentials:NP, RN
Authorized Official - Phone:909-256-3700
Mailing Address - Street 1:222 N MOUNTAIN AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-5714
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:222 N MOUNTAIN AVE STE 204
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-5714
Practice Address - Country:US
Practice Address - Phone:909-256-3700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CONNECTA HEALTHCARE SERVICES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-09-30
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based