Provider Demographics
NPI:1841063047
Name:MONREAL HOME HEALTH LLC
Entity type:Organization
Organization Name:MONREAL HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MELIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:PINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-513-2182
Mailing Address - Street 1:1130 N ORANGE ST APT 2
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92501
Mailing Address - Country:US
Mailing Address - Phone:619-513-2182
Mailing Address - Fax:
Practice Address - Street 1:1264 S WATERMAN AVE STE 33
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92408-2849
Practice Address - Country:US
Practice Address - Phone:619-513-2182
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-31
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164X00000XNursing Service ProvidersLicensed Vocational NurseGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty