Healthcare Provider Details

I. General information

NPI: 1750114435
Provider Name (Legal Business Name): HRH FORTUNE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2024
Last Update Date: 01/14/2026
Certification Date: 01/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1303 E GRAND AVE STE 111
ARROYO GRANDE CA
93420-2461
US

IV. Provider business mailing address

320 PABLO LN
NIPOMO CA
93444-9257
US

V. Phone/Fax

Practice location:
  • Phone: 805-931-4154
  • Fax:
Mailing address:
  • Phone: 805-710-7279
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: KRISTI EDWARDS
Title or Position: MANAGING MEMBER
Credential:
Phone: 805-710-7279