Healthcare Provider Details

I. General information

NPI: 1871284828
Provider Name (Legal Business Name): MASAGANA HOME CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2023
Last Update Date: 05/18/2023
Certification Date: 05/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12101 165TH ST
NORWALK CA
90650-7255
US

IV. Provider business mailing address

12101 165TH ST
NORWALK CA
90650-7255
US

V. Phone/Fax

Practice location:
  • Phone: 818-356-8828
  • Fax: 818-714-8008
Mailing address:
  • Phone: 818-356-8828
  • Fax: 818-714-8008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: LENI GRACE LAGASCA
Title or Position: CEO
Credential:
Phone: 818-356-8828