Healthcare Provider Details

I. General information

NPI: 1609863547
Provider Name (Legal Business Name): MULTI-SKILLED HOME CARE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19608 CAMINO DE ROSA
WALNUT CA
91789-2103
US

IV. Provider business mailing address

19608 CAMINO DE ROSA
WALNUT CA
91789-2103
US

V. Phone/Fax

Practice location:
  • Phone: 909-595-0200
  • Fax: 909-595-1211
Mailing address:
  • Phone: 909-595-0200
  • Fax: 909-595-1211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MS. MARIA BRENDA ILAGAN
Title or Position: ADMINISTRATOR DPCS
Credential: R.N.
Phone: 909-595-0200