Healthcare Provider Details

I. General information

NPI: 1346128816
Provider Name (Legal Business Name): 365 HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2025
Last Update Date: 08/28/2025
Certification Date: 08/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10225 AUSTIN DR STE 208
SPRING VALLEY CA
91978-1522
US

IV. Provider business mailing address

10225 AUSTIN DR STE 208
SPRING VALLEY CA
91978-1522
US

V. Phone/Fax

Practice location:
  • Phone: 619-439-7289
  • Fax:
Mailing address:
  • Phone: 858-828-6121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: TEMITOPE OWOLABI
Title or Position: HR SPECIALIST
Credential:
Phone: 858-828-6121