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General NPI Number Information
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NPI Number | 1023381563
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Entity Type | Organization
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Legal Business Name | GHSD, LLC
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Dates
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Enumeration Date | 02/14/2012
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Last Update Date | 09/19/2012
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Provider Practice Location Address
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Address Line | 206 BIRMINGHAM DR
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City | CARDIFF
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State | CA
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Zip | 92007-1722
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Country | US
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Telephone | 760-230-6446
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Fax | 760-230-6447
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Provider Business Mailing Address
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Address Line | 206 BIRMINGHAM DR
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City | CARDIFF
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State | CA
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Zip | 92007-1722
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Country | US
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Telephone | 760-230-6446
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Fax | 760-230-6447
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL/COMP OFFICER
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Name | LUCILA R DEANDA
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Credential | COMPLIANCE OFFICER
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Telephone | 760-230-6446
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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 | CA
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