Healthcare Provider Details

I. General information

NPI: 1285050724
Provider Name (Legal Business Name): ENCOMPASS CONSULTING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2014
Last Update Date: 03/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2015 CABRILLO LN
HERCULES CA
94547-5419
US

IV. Provider business mailing address

2015 CABRILLO LN
HERCULES CA
94547-5419
US

V. Phone/Fax

Practice location:
  • Phone: 866-936-7838
  • Fax: 866-936-7840
Mailing address:
  • Phone: 866-936-7838
  • Fax: 866-936-7840

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License NumberPB1434
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License NumberPB1434
License Number StateCA

VIII. Authorized Official

Name: MS. MAI CHUNG
Title or Position: EXECUTIVE DIRECTOR/FOUNDER
Credential:
Phone: 866-936-7838