Healthcare Provider Details

I. General information

NPI: 1437914918
Provider Name (Legal Business Name): DOROTHY'S DAUGHTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2024
Last Update Date: 02/14/2024
Certification Date: 02/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 N LAKE AVE
PASADENA CA
91104-1228
US

IV. Provider business mailing address

2181 E FOOTHILL BLVD STE 203
PASADENA CA
91107-6825
US

V. Phone/Fax

Practice location:
  • Phone: 626-298-6135
  • Fax:
Mailing address:
  • Phone: 626-298-6135
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number State

VIII. Authorized Official

Name: DOROTHY SIMPSON
Title or Position: PRESIDENT
Credential:
Phone: 626-298-6135