Provider Demographics
NPI:1982607461
Name:DURBAN INVESTMENT INC.
Entity Type:Organization
Organization Name:DURBAN INVESTMENT INC.
Other - Org Name:SIERRA HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:NDUBISI
Authorized Official - Last Name:OBI
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:909-349-0036
Mailing Address - Street 1:9161 SIERRA AVE
Mailing Address - Street 2:STE 201A
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92335-4773
Mailing Address - Country:US
Mailing Address - Phone:909-349-0036
Mailing Address - Fax:909-349-0039
Practice Address - Street 1:9161 SIERRA AVE
Practice Address - Street 2:STE 201A
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92335-4773
Practice Address - Country:US
Practice Address - Phone:909-349-0036
Practice Address - Fax:909-349-0039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHHA08022GMedicaid
CA058022Medicare ID - Type UnspecifiedHOME HEALTH AGENCY