Provider Demographics
NPI:1548604242
Name:ENHANCING FORWARD ACTION, INC
Entity Type:Organization
Organization Name:ENHANCING FORWARD ACTION, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TAMMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LOZOLLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-877-3332
Mailing Address - Street 1:PO BOX 2406
Mailing Address - Street 2:
Mailing Address - City:RIALTO
Mailing Address - State:CA
Mailing Address - Zip Code:92377-2406
Mailing Address - Country:US
Mailing Address - Phone:909-877-3332
Mailing Address - Fax:
Practice Address - Street 1:135 W RIALTO AVE
Practice Address - Street 2:
Practice Address - City:RIALTO
Practice Address - State:CA
Practice Address - Zip Code:92376-6409
Practice Address - Country:US
Practice Address - Phone:909-877-3332
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-24
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care