Healthcare Provider Details
I. General information
NPI: 1275468316
Provider Name (Legal Business Name): GREATER LIVING & CARE LL
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2509 CAROLYN DRIVE
PALMDALE CA
93551
US
IV. Provider business mailing address
550 W RANCHO VISTA BLVD STE D
PALMDALE CA
93551-3011
US
V. Phone/Fax
- Phone: 661-760-6736
- Fax:
- Phone: 661-760-6736
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
DAVID
BARRON
WOODMAN
II
Title or Position: MANAGING MEMBER/ CEO
Credential:
Phone: 661-760-6736