Healthcare Provider Details

I. General information

NPI: 1891177044
Provider Name (Legal Business Name): MY CARE PROFESSIONALS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2015
Last Update Date: 06/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6060 W MANCHESTER AVE SUITE 315
LOS ANGELES CA
90045-4200
US

IV. Provider business mailing address

6060 W MANCHESTER AVE SUITE 315
LOS ANGELES CA
90045-4200
US

V. Phone/Fax

Practice location:
  • Phone: 877-877-5558
  • Fax: 877-667-7642
Mailing address:
  • Phone: 877-877-5558
  • Fax: 877-667-7642

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number StateNULL
# 4
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number StateNULL

VIII. Authorized Official

Name: NATHAN DRATI
Title or Position: CLINICAL DIRECTOR
Credential: R.N. MSN
Phone: 877-877-5558