Provider Demographics
NPI:1174402945
Name:PSALM71:9 LLC
Entity type:Organization
Organization Name:PSALM71:9 LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT C.E.O.
Authorized Official - Prefix:
Authorized Official - First Name:BEAU
Authorized Official - Middle Name:
Authorized Official - Last Name:BRIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-434-3298
Mailing Address - Street 1:8692 VICARA DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91701-1375
Mailing Address - Country:US
Mailing Address - Phone:909-434-3298
Mailing Address - Fax:
Practice Address - Street 1:8692 VICARA DR
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91701-1375
Practice Address - Country:US
Practice Address - Phone:909-434-3298
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-27
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care