Healthcare Provider Details

I. General information

NPI: 1942053202
Provider Name (Legal Business Name): FOYER HOME HEALTH SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2024
Last Update Date: 04/08/2024
Certification Date: 04/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17439 FAIRLIE RD
SAN DIEGO CA
92128-3953
US

IV. Provider business mailing address

17439 FAIRLIE RD
SAN DIEGO CA
92128-3953
US

V. Phone/Fax

Practice location:
  • Phone: 858-205-7580
  • Fax:
Mailing address:
  • Phone: 858-205-7580
  • Fax:

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: IRVING ALGERELL WALL
Title or Position: OWNER/ADMINISTRATOR
Credential: M.B.A.
Phone: 858-205-7580