Healthcare Provider Details

I. General information

NPI: 1891470027
Provider Name (Legal Business Name): IT TAKES A VILLAGE VETERANS IN HOME CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2023
Last Update Date: 06/16/2023
Certification Date: 06/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 1ST AVE SW STE A
WATERTOWN SD
57201-3507
US

IV. Provider business mailing address

322 MAIN ST STE 3
SEAL BEACH CA
90740-6350
US

V. Phone/Fax

Practice location:
  • Phone: 605-939-0277
  • Fax:
Mailing address:
  • Phone: 805-698-2852
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State

VIII. Authorized Official

Name: NICHOLE MULLER
Title or Position: OWNER
Credential:
Phone: 805-698-2852