Provider Demographics
NPI:1407916786
Name:C & F HOME HEALTH AGENCY INC.
Entity Type:Organization
Organization Name:C & F HOME HEALTH AGENCY INC.
Other - Org Name:C & F HOME HEALTH AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESINDENT ADMINISTRATOR DPCS
Authorized Official - Prefix:MRS
Authorized Official - First Name:GRICELDA
Authorized Official - Middle Name:CECILIA
Authorized Official - Last Name:CAMPOS
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:909-952-0990
Mailing Address - Street 1:4959 PALO VERDE ST
Mailing Address - Street 2:103A-5
Mailing Address - City:MONTCLAIR
Mailing Address - State:CA
Mailing Address - Zip Code:91763-2331
Mailing Address - Country:US
Mailing Address - Phone:909-626-9575
Mailing Address - Fax:909-626-9575
Practice Address - Street 1:4959 PALO VERDE ST
Practice Address - Street 2:103A-5
Practice Address - City:MONTCLAIR
Practice Address - State:CA
Practice Address - Zip Code:91763-2331
Practice Address - Country:US
Practice Address - Phone:909-626-9575
Practice Address - Fax:909-626-9575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC2889699251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health