Provider Demographics
NPI:1699367714
Name:IENRICHMENT HOME HEALTH CARE
Entity Type:Organization
Organization Name:IENRICHMENT HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADEGBOYEGA
Authorized Official - Middle Name:ABIODUN
Authorized Official - Last Name:AGBELUSI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-232-0994
Mailing Address - Street 1:222 N MOUNTAIN AVE STE 221B
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-5714
Mailing Address - Country:US
Mailing Address - Phone:909-687-0604
Mailing Address - Fax:909-498-1122
Practice Address - Street 1:222 N MOUNTAIN AVE STE 221B
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-5714
Practice Address - Country:US
Practice Address - Phone:909-687-0604
Practice Address - Fax:909-498-1122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-10
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health