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General NPI Number Information
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NPI Number | 1013651520
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Entity Type | Organization
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Legal Business Name | ANGELENO COMMUNITY HOME HEALTH INC.
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Dates
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Enumeration Date | 04/21/2022
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Last Update Date | 04/21/2022
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Provider Practice Location Address
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Address Line | 925 S ATLANTIC BLVD STE 204A
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City | MONTEREY PARK
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State | CA
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Zip | 91754-1063
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Country | US
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Telephone | 626-641-2911
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Fax |
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Provider Business Mailing Address
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Address Line | 925 S ATLANTIC BLVD STE 204A
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City | MONTEREY PARK
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State | CA
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Zip | 91754-1063
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | OLIVIA VALLEJO-GONZALEZ
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Credential |
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Telephone | 323-420-3470
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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