Provider Demographics
NPI:1588961478
Name:DAMEKOLA NURSING AGENCY
Entity type:Organization
Organization Name:DAMEKOLA NURSING AGENCY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:BALOGUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-531-8657
Mailing Address - Street 1:635 VIEW LN
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92881-8347
Mailing Address - Country:US
Mailing Address - Phone:951-531-8657
Mailing Address - Fax:951-496-4166
Practice Address - Street 1:635 VIEW LN
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92881-8347
Practice Address - Country:US
Practice Address - Phone:951-531-8657
Practice Address - Fax:951-496-4166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-11
Last Update Date:2011-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health