Provider Demographics
NPI:1790360550
Name:SUSTAINABLE HEALTH INITIATIVE INC
Entity Type:Organization
Organization Name:SUSTAINABLE HEALTH INITIATIVE INC
Other - Org Name:INLAND VALLEY HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:ARIF
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-225-2721
Mailing Address - Street 1:21809 PAINT BRUSH LN
Mailing Address - Street 2:
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91765-2834
Mailing Address - Country:US
Mailing Address - Phone:909-225-2721
Mailing Address - Fax:909-736-3113
Practice Address - Street 1:404 S PROSPECTORS RD STE A
Practice Address - Street 2:
Practice Address - City:DIAMOND BAR
Practice Address - State:CA
Practice Address - Zip Code:91765-1617
Practice Address - Country:US
Practice Address - Phone:909-225-2721
Practice Address - Fax:909-736-3113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-13
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health