Healthcare Provider Details

I. General information

NPI: 1205764511
Provider Name (Legal Business Name): AT HOME CARE AND COMPANIONSHIP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2026
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2911 W 130TH ST
GARDENA CA
90249-1510
US

IV. Provider business mailing address

2911 W 130TH ST
GARDENA CA
90249-1510
US

V. Phone/Fax

Practice location:
  • Phone: 945-326-4410
  • Fax:
Mailing address:
  • Phone: 945-326-4410
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name: JIMISE JOYCE PHILLIPS
Title or Position: OWNER
Credential: RN
Phone: 945-326-4410