Provider Demographics
NPI:1629345582
Name:AMERICAN COMPANION AND CAREGIVERS
Entity Type:Organization
Organization Name:AMERICAN COMPANION AND CAREGIVERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DANELLE
Authorized Official - Middle Name:L
Authorized Official - Last Name:HONIKEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-231-7820
Mailing Address - Street 1:PO BOX 1740
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91729-1740
Mailing Address - Country:US
Mailing Address - Phone:909-373-8670
Mailing Address - Fax:909-373-8671
Practice Address - Street 1:11023 EUCALYPTUS ST STE 102
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-7691
Practice Address - Country:US
Practice Address - Phone:909-373-8670
Practice Address - Fax:909-373-8671
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-21
Last Update Date:2011-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA052705251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health