Provider Demographics
NPI:1558037374
Name:ST. FRANCIS HOME HEALTH AGENCY, INC.
Entity Type:Organization
Organization Name:ST. FRANCIS HOME HEALTH AGENCY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARTINS
Authorized Official - Middle Name:
Authorized Official - Last Name:AIYETIWA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-989-7700
Mailing Address - Street 1:10970 ARROW RTE STE 205
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-4839
Mailing Address - Country:US
Mailing Address - Phone:909-989-7700
Mailing Address - Fax:
Practice Address - Street 1:10970 ARROW RTE STE 205
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-4839
Practice Address - Country:US
Practice Address - Phone:909-989-7700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-20
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health