Healthcare Provider Details

I. General information

NPI: 1942899208
Provider Name (Legal Business Name): NEW WAVE HOME HEALTH CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2021
Last Update Date: 01/12/2021
Certification Date: 01/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6365 VAN NUYS BLVD STE 3
VAN NUYS CA
91401-2670
US

IV. Provider business mailing address

6365 VAN NUYS BLVD STE 3
VAN NUYS CA
91401-2670
US

V. Phone/Fax

Practice location:
  • Phone: 818-616-4352
  • Fax:
Mailing address:
  • Phone: 818-616-4352
  • 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: CREESY AMORE
Title or Position: CEO
Credential:
Phone: 818-616-4352