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General NPI Number Information
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NPI Number | 1013061597
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Entity Type | Organization
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Legal Business Name | DEANCO HEALTHCARE LLC.
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Dates
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Enumeration Date | 01/22/2007
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Last Update Date | 08/28/2023
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Provider Practice Location Address
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Address Line | 14850 ROSCOE BLVD
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City | PANORAMA CITY
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State | CA
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Zip | 91402
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Country | US
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Telephone | 818-787-2222
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Fax | 818-904-3650
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Provider Business Mailing Address
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Address Line | 14850 ROSCOE BLVD
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City | PANORAMA CITY
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State | CA
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Zip | 91402
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Country | US
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Telephone | 818-787-2222
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Fax | 818-904-3650
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MIHI LEE
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Credential |
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Telephone | 818-304-8644
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273R00000X
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Taxonomy Name | Psychiatric Hospital Unit
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License Number | 930000101
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License Number State | CA
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