Healthcare Provider Details

I. General information

NPI: 1760594014
Provider Name (Legal Business Name): GENTLE CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 01/30/2020
Certification Date: 01/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3701 STOCKER ST STE 106
VIEW PARK CA
90008-5145
US

IV. Provider business mailing address

4600 DON LORENZO DR APT 34
LOS ANGELES CA
90008-5510
US

V. Phone/Fax

Practice location:
  • Phone: 310-216-2967
  • Fax: 310-216-9267
Mailing address:
  • Phone: 323-295-0047
  • Fax: 323-295-0052

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number550000174
License Number StateCA

VIII. Authorized Official

Name: MARY LOUISE CRAIG
Title or Position: DPCS
Credential: REGISTERED NURSE
Phone: 323-273-2220