Healthcare Provider Details

I. General information

NPI: 1710029541
Provider Name (Legal Business Name): DWC HOME CARE,INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15340 MANZANARES RD
LA MIRADA CA
90638-3949
US

IV. Provider business mailing address

16551 E. MURPHY ROAD
LA MIRADA CA
90638
US

V. Phone/Fax

Practice location:
  • Phone: 562-943-9018
  • Fax: 562-947-2802
Mailing address:
  • Phone: 310-386-4235
  • Fax: 562-947-2802

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code315P00000X
TaxonomyIntellectual Disabilities Intermediate Care Facility
License Number
License Number StateCA

VIII. Authorized Official

Name: MRS. MARIA LUISA FRANCO DE LEON
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 310-386-4235