Healthcare Provider Details

I. General information

NPI: 1104506765
Provider Name (Legal Business Name): GOOD SHEPHERD CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2023
Last Update Date: 07/19/2023
Certification Date: 07/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25336 VIA PACIFICA
SANTA CLARITA CA
91355
US

IV. Provider business mailing address

25336 VIA PACIFICA
SANTA CLARITA CA
91355
US

V. Phone/Fax

Practice location:
  • Phone: 818-428-5352
  • Fax:
Mailing address:
  • Phone: 626-552-6720
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: PHILIP ZHOU
Title or Position: CEO
Credential: DO
Phone: 626-552-6720