Healthcare Provider Details

I. General information

NPI: 1811711617
Provider Name (Legal Business Name): HOLY SPRINGS HOME HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2024
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 W MAIN AVE STE D
MORGAN HILL CA
95037-4567
US

IV. Provider business mailing address

50 W MAIN AVE
MORGAN HILL CA
95037-4574
US

V. Phone/Fax

Practice location:
  • Phone: 408-638-5770
  • Fax:
Mailing address:
  • Phone: 669-286-9631
  • Fax: 408-608-0441

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: VERANOEL T ENDAH
Title or Position: OWNER, PRESIDENT
Credential: RN
Phone: 669-286-9631