Healthcare Provider Details

I. General information

NPI: 1578158267
Provider Name (Legal Business Name): ENJOY THE MOMENT'S SENIOR CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2021
Last Update Date: 10/06/2022
Certification Date: 10/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5505 SANTA ANA CANYON ROAD
ANAHEIM CA
92817
US

IV. Provider business mailing address

5505 SANTA CANYON ROAD 17971
ANAHEIM CA
92517
US

V. Phone/Fax

Practice location:
  • Phone: 949-973-1524
  • Fax: 310-920-3400
Mailing address:
  • Phone: 310-920-3400
  • Fax: 310-920-3400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: CANDACE QUATINA BUTLER
Title or Position: MANAGER
Credential:
Phone: 310-920-3400