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General NPI Number Information
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NPI Number | 1053748285
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Entity Type | Organization
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Legal Business Name | AT HOME SENIOR CARE SERVICES LLC
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Dates
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Enumeration Date | 10/02/2013
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Last Update Date | 10/02/2013
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Provider Practice Location Address
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Address Line | 20628 E ARROW HWY STE 2
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City | COVINA
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State | CA
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Zip | 91724-1343
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Country | US
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Telephone | 626-252-8141
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Fax | 888-800-1432
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Provider Business Mailing Address
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Address Line | 20628 E ARROW HWY STE 2
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City | COVINA
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State | CA
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Zip | 91724-1343
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Country | US
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Telephone | 626-252-8141
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Fax | 888-800-1432
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Authorized Official
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Title or Position | CEO/ FOUNDER
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Name | MRS. BELLE C DECINA
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Credential | M.A. ED
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Telephone | 626-252-8141
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 0001715
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 201206710241
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License Number State | CA
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