Provider Demographics
NPI:1508399312
Name:SAN BERNARDINO HOME HEALTH INC
Entity Type:Organization
Organization Name:SAN BERNARDINO HOME HEALTH INC
Other - Org Name:SAN BERNARDINO HOME HEALTH, INC .
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:B
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-739-4880
Mailing Address - Street 1:600 N MOUNTAIN AVE #C202
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-4367
Mailing Address - Country:US
Mailing Address - Phone:909-966-4852
Mailing Address - Fax:310-878-0326
Practice Address - Street 1:600 N MOUNTAIN AVE #C202
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-4367
Practice Address - Country:US
Practice Address - Phone:909-966-4852
Practice Address - Fax:310-878-0326
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-07
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health