Healthcare Provider Details

I. General information

NPI: 1699033522
Provider Name (Legal Business Name): UTS HOME HEALTHCARE GROUP, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2012
Last Update Date: 04/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3711 LONG BEACH BLVD SUITE 806A
LONG BEACH CA
90807-3315
US

IV. Provider business mailing address

3711 LONG BEACH BLVD SUITE 806A
LONG BEACH CA
90807-3315
US

V. Phone/Fax

Practice location:
  • Phone: 310-713-8969
  • Fax:
Mailing address:
  • Phone: 310-713-8969
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number515412
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number515412
License Number StateCA

VIII. Authorized Official

Name: MS. THERESA AWUJO
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 310-713-8969