Healthcare Provider Details

I. General information

NPI: 1093261166
Provider Name (Legal Business Name): ASSURITY HOMECARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2016
Last Update Date: 08/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9110 IRVINE CENTER DR
IRVINE CA
92618-4659
US

IV. Provider business mailing address

9110 IRVINE CENTER DR
IRVINE CA
92618-4659
US

V. Phone/Fax

Practice location:
  • Phone: 818-268-1704
  • Fax:
Mailing address:
  • Phone: 818-268-1704
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number304700078
License Number StateCA

VIII. Authorized Official

Name: MR. BEN BOLLARD
Title or Position: MANAGER
Credential:
Phone: 818-268-1704