Provider Demographics
NPI:1821372202
Name:INLAND WELLNESS HEALTH CARE, INC.
Entity Type:Organization
Organization Name:INLAND WELLNESS HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HAKOB
Authorized Official - Middle Name:
Authorized Official - Last Name:BABAJANYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-579-0077
Mailing Address - Street 1:869 E FOOTHILL BLVD
Mailing Address - Street 2:SUITE I-B
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-4011
Mailing Address - Country:US
Mailing Address - Phone:909-579-0077
Mailing Address - Fax:909-579-0770
Practice Address - Street 1:869 E FOOTHILL BLVD
Practice Address - Street 2:SUITE I-B
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-4011
Practice Address - Country:US
Practice Address - Phone:909-579-0077
Practice Address - Fax:909-579-0770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-04
Last Update Date:2017-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA059552Medicare Oscar/Certification