Healthcare Provider Details

I. General information

NPI: 1457261737
Provider Name (Legal Business Name): HEAVENLY GRACE HOME HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 HOSPITAL CIR
WESTMINSTER CA
92683-3953
US

IV. Provider business mailing address

250 HOSPITAL CIR
WESTMINSTER CA
92683-3953
US

V. Phone/Fax

Practice location:
  • Phone: 714-373-0123
  • Fax:
Mailing address:
  • Phone: 714-373-0123
  • 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: XUAN TRIEU
Title or Position: OWNER/ ADMINISTRATOR
Credential:
Phone: 714-858-3535