Healthcare Provider Details

I. General information

NPI: 1861503161
Provider Name (Legal Business Name): CHARITY HOME HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 06/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 E CARSON PLAZA DR #228
CARSON CA
90746-3225
US

IV. Provider business mailing address

500 E CARSON PLAZA DR #228
CARSON CA
90746-3225
US

V. Phone/Fax

Practice location:
  • Phone: 310-527-4339
  • Fax:
Mailing address:
  • Phone: 310-527-4339
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number980001063
License Number StateCA

VIII. Authorized Official

Name: MR. TOBENNA ONWUNYI
Title or Position: ADMINISTRATOR
Credential:
Phone: 310-527-4339