Healthcare Provider Details

I. General information

NPI: 1144591504
Provider Name (Legal Business Name): FOUR SEASONS HOME HEALTH SERVICES CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2012
Last Update Date: 01/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21000 DEVONSHIRE ST SUITE 103A
CHATSWORTH CA
91311-2360
US

IV. Provider business mailing address

21000 DEVONSHIRE ST SUITE 103A
CHATSWORTH CA
91311-2360
US

V. Phone/Fax

Practice location:
  • Phone: 818-812-9719
  • Fax: 818-626-9843
Mailing address:
  • Phone: 818-812-9719
  • Fax: 818-626-9843

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number550001753
License Number StateCA

VIII. Authorized Official

Name: MR. EVERARDO GARCIA SOLORZANO
Title or Position: CEO
Credential: RN
Phone: 818-812-9719