Provider Demographics
NPI:1730643974
Name:MAYBERRY CARE, INC.
Entity Type:Organization
Organization Name:MAYBERRY CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALINA
Authorized Official - Middle Name:
Authorized Official - Last Name:TORAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-982-4646
Mailing Address - Street 1:172 D ST
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-4707
Mailing Address - Country:US
Mailing Address - Phone:909-982-4646
Mailing Address - Fax:909-256-3608
Practice Address - Street 1:172 D ST
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-4707
Practice Address - Country:US
Practice Address - Phone:909-982-4646
Practice Address - Fax:909-256-3608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-22
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care