Provider Demographics
NPI:1215503768
Name:CARRY ME HOME INC
Entity type:Organization
Organization Name:CARRY ME HOME INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARIA CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHUA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-904-7003
Mailing Address - Street 1:5787 LITTLE SHAY DR
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92336-4593
Mailing Address - Country:US
Mailing Address - Phone:909-904-7003
Mailing Address - Fax:909-945-9799
Practice Address - Street 1:5787 LITTLE SHAY DR
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92336-4593
Practice Address - Country:US
Practice Address - Phone:909-904-7003
Practice Address - Fax:909-945-9799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-03
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251V00000XAgenciesVoluntary or Charitable
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No174200000XOther Service ProvidersMeals
No177F00000XOther Service ProvidersLodging
No251B00000XAgenciesCase Management
No311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility
No385H00000XRespite Care FacilityRespite CareGroup - Multi-Specialty