Healthcare Provider Details

I. General information

NPI: 1447961701
Provider Name (Legal Business Name): DESCENDANTS ADVOCACY & HOME CARE AGENCY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2022
Last Update Date: 12/07/2022
Certification Date: 12/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

717 W SACRAMENTO ST
ALTADENA CA
91001-5224
US

IV. Provider business mailing address

717 W SACRAMENTO ST
ALTADENA CA
91001-5224
US

V. Phone/Fax

Practice location:
  • Phone: 626-484-4995
  • Fax:
Mailing address:
  • Phone: 626-484-4995
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: BEVERLY HARMON
Title or Position: MANAGER MEMBER/ADMINISTRATOR
Credential:
Phone: 888-516-0268