Provider Demographics
NPI:1720378052
Name:HANG BOK,INC
Entity Type:Organization
Organization Name:HANG BOK,INC
Other - Org Name:SUNNY HILLS HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUNG
Authorized Official - Middle Name:BOK
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:951-924-3289
Mailing Address - Street 1:26600 IRONWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92555-1716
Mailing Address - Country:US
Mailing Address - Phone:951-924-3289
Mailing Address - Fax:951-780-3157
Practice Address - Street 1:26600 IRONWOOD AVE
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92555-1716
Practice Address - Country:US
Practice Address - Phone:951-924-3289
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-07
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA336409480310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility