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General NPI Number Information
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NPI Number | 1073736757
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Entity Type | Organization
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Legal Business Name | VIP HOME CARE LLC
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 25920 IRIS AVE STE 13A-267
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City | MORENO VALLEY
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State | CA
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Zip | 92551-1658
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Country | US
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Telephone | 888-847-0171
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Fax |
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Provider Business Mailing Address
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Address Line | 25920 IRIS AVE STE 13A-267
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City | MORENO VALLEY
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State | CA
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Zip | 92551-1658
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Country | US
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Telephone | 888-847-0171
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MS. VIOLA MITCHELL
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Credential |
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Telephone | 888-847-0171
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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 | 200633310002
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License Number State | CA
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