Provider Demographics
NPI:1932351475
Name:TEAM NURSES HOME HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:TEAM NURSES HOME HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:MAGDALENE
Authorized Official - Middle Name:I
Authorized Official - Last Name:AGBOGHIDI
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:909-881-5956
Mailing Address - Street 1:1815 NORTH D ST
Mailing Address - Street 2:
Mailing Address - City:SAN BERNADINO
Mailing Address - State:CA
Mailing Address - Zip Code:92405-3909
Mailing Address - Country:US
Mailing Address - Phone:909-881-5953
Mailing Address - Fax:909-658-6348
Practice Address - Street 1:1815 N D ST
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92405-3909
Practice Address - Country:US
Practice Address - Phone:909-881-5953
Practice Address - Fax:909-658-6348
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-15
Last Update Date:2014-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN184284251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health