Healthcare Provider Details

I. General information

NPI: 1114782471
Provider Name (Legal Business Name): HEALING HOMECARE AGENCY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2024
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 S ATLANTIC BLVD STE 205A
MONTEREY PARK CA
91754-1097
US

IV. Provider business mailing address

925 S ATLANTIC BLVD STE 205A
MONTEREY PARK CA
91754-1097
US

V. Phone/Fax

Practice location:
  • Phone: 626-628-0515
  • Fax: 626-537-1004
Mailing address:
  • Phone: 626-628-0515
  • Fax: 626-537-1004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: QUOC NGUYEN
Title or Position: OWNER/PRESIDENT
Credential:
Phone: 415-481-8006