Healthcare Provider Details

I. General information

NPI: 1639242746
Provider Name (Legal Business Name): DEPENDABLE HOME HEALTH, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2006
Last Update Date: 08/13/2021
Certification Date: 08/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16922 AIRPORT BLVD BUILDING 1, SUIT 17
MOJAVE CA
93501-1655
US

IV. Provider business mailing address

16922 AIRPORT BLVD BLDG 1 #17
MOJAVE CA
93501
US

V. Phone/Fax

Practice location:
  • Phone: 661-824-0133
  • Fax: 661-824-0134
Mailing address:
  • Phone: 661-824-0133
  • Fax: 661-824-0134

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number550000694
License Number StateCA

VIII. Authorized Official

Name: RIMMA SHVARTS
Title or Position: ADMINISTRATOR
Credential: DPCS
Phone: 661-824-0133