Provider Demographics
NPI:1407493562
Name:ALLSTAR MEDICAL RESPITE AND RECUPERATIVE CARE
Entity Type:Organization
Organization Name:ALLSTAR MEDICAL RESPITE AND RECUPERATIVE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARIA CATHERINE
Authorized Official - Middle Name:KOH
Authorized Official - Last Name:CHUA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-945-9899
Mailing Address - Street 1:9521 BUSINESS CENTER DR STE 9-101
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-7704
Mailing Address - Country:US
Mailing Address - Phone:909-945-9899
Mailing Address - Fax:
Practice Address - Street 1:1160 ARIZONA ST
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92374-2816
Practice Address - Country:US
Practice Address - Phone:909-945-9899
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALLSTAR HEALTH PROVIDERS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-12-06
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes177F00000XOther Service ProvidersLodging
No251B00000XAgenciesCase Management
No251K00000XAgenciesPublic Health or Welfare