Provider Demographics
NPI:1174525380
Name:VISITING NURSE ASSOCIATION OF THE INLAND COUNTIES
Entity type:Organization
Organization Name:VISITING NURSE ASSOCIATION OF THE INLAND COUNTIES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RAJNIT
Authorized Official - Middle Name:
Authorized Official - Last Name:WALIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-413-1200
Mailing Address - Street 1:6235 RIVER CREST DR
Mailing Address - Street 2:STE L
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92507-0758
Mailing Address - Country:US
Mailing Address - Phone:951-413-1270
Mailing Address - Fax:951-413-1208
Practice Address - Street 1:6235 RIVER CREST DR
Practice Address - Street 2:STE L
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92507-0758
Practice Address - Country:US
Practice Address - Phone:951-413-1200
Practice Address - Fax:951-413-1208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-01
Last Update Date:2019-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA250000025251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA197679402OtherACS DEPT OF LABOR PROV #
CA197679403OtherACS DEPT OF LABOR PROV #
CA197679401OtherACS DEPT OF LABOR PROV #
CA197679404OtherACS DEPT OF LABOR PROV #
CA197679406OtherACS DEPT OF LABOR PROV #
CAZZT07013FMedicaid
CA197679405OtherACS DEPT OF LABOR PROV #
CAZZZ34754ZOtherBLUE SHIELD PROVIDER # HH
CA197679400OtherACS DEPT. OF LABOR PROV #
CA197679402OtherACS DEPT OF LABOR PROV #