Healthcare Provider Details

I. General information

NPI: 1225670904
Provider Name (Legal Business Name): BEWISE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2019
Last Update Date: 10/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22214 VANOWEN ST
WOODLAND HILLS CA
91303-2401
US

IV. Provider business mailing address

22214 VANOWEN ST
WOODLAND HILLS CA
91303-2401
US

V. Phone/Fax

Practice location:
  • Phone: 818-300-4994
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: CHINWEIKE OKONKWO
Title or Position: PRESIDENT / CEO
Credential:
Phone: 818-300-4994