Healthcare Provider Details

I. General information

NPI: 1053056200
Provider Name (Legal Business Name): ANC HOME HEALTH SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2022
Last Update Date: 05/02/2022
Certification Date: 05/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14501 CALVERT ST STE 204
VAN NUYS CA
91411-2806
US

IV. Provider business mailing address

14501 CALVERT ST STE 204
VAN NUYS CA
91411-2806
US

V. Phone/Fax

Practice location:
  • Phone: 818-824-1127
  • Fax:
Mailing address:
  • Phone:
  • 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: MR. JOSE SANTOS
Title or Position: CEO
Credential:
Phone: 818-824-1127