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General NPI Number Information
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NPI Number | 1033559356
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Entity Type | Organization
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Legal Business Name | MEMORIALCARE HOME HEALTH - LLC
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Dates
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Enumeration Date | 07/01/2013
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Last Update Date | 07/01/2013
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Provider Practice Location Address
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Address Line | 23521 PASEO DE VALENCIA STE 100
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-3126
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Country | US
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Telephone | 949-452-3626
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Fax | 949-452-3460
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Provider Business Mailing Address
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Address Line | 23521 PASEO DE VALENCIA STE 100
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-3126
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Country | US
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Telephone | 949-452-3626
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Fax | 949-452-3460
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Authorized Official
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Title or Position | CFO
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Name | MR. ADOLFO OSCAR CHANEZ
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Credential | CPA
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Telephone | 949-452-3644
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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 | 060000218
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License Number State | CA
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