Great I Am Welfare and Development Home Health Agency LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

201312310016 Issued in CA

Legal business name

GREAT I AM WELFARE AND DEVELOPMENT HOME HEALTH AGENCY LLC

Practice address

14189 Foothill Blvd
102
Fontana, CA 92335-3093

Phone

(909) 329-3024

NPI assigned

May 9, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Carroll A Green Sr.

Title

Owner

Phone

90932920334

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1368057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372636800000",
    "number": "1871938373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14189 FOOTHILL BLVD",
            "address_2": "102",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923353093",
            "telephone_number": "909-329-3024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14189 FOOTHILL BLVD",
            "address_2": "102",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923353093",
            "telephone_number": "909-329-3024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT I AM WELFARE AND DEVELOPMENT HOME HEALTH AGENCY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-09",
        "last_updated": "2013-07-01",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "CARROLL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "90932920334",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": "201312310016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carolina Gradilla
• George Miller Grames, M.D.
• Karin Irene Granberg, M.P.T., D.SC.
• Alicia Christina Gray, MS
• Summer Margaret Gray
• Green Merrylands Inc
• Dominnique Green
• Henrietta Anne Green, PA-C
• Damon Lamont Greene, M.D.
• Tambra Greene, LCSW

• Home Health Agency in Fontana, CA
• Providers in Fontana, CA by specialty
• Home Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.