Healthcare Provider Details
I. General information
NPI: 1669610077
Provider Name (Legal Business Name): CITY OF DREAMS HOME HEALTH CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/23/2009
Last Update Date: 01/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5924 E LOS ANGELES AVE STE P
SIMI VALLEY CA
93063-5526
US
IV. Provider business mailing address
5924 E LOS ANGELES AVE STE P
SIMI VALLEY CA
93063-5526
US
V. Phone/Fax
- Phone: 805-520-3036
- Fax: 805-520-3037
- Phone: 805-520-3036
- Fax: 805-520-3037
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | 163WH0200X |
| License Number State | CA |
VIII. Authorized Official
Name: MRS.
NAIRA
TSHOROKHYAN
Title or Position: CEO
Credential:
Phone: 805-520-3036