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General NPI Number Information
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NPI Number | 1154624443
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Entity Type | Organization
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Legal Business Name | CHARTER HEALTH CARE GROUP LLC
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Dates
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Enumeration Date | 12/08/2010
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Last Update Date | 02/03/2022
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Provider Practice Location Address
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Address Line | 970 S VILLAGE OAKS DR SUITE 102
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City | COVINA
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State | CA
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Zip | 91724-3626
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Country | US
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Telephone | 626-915-7490
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Fax | 626-915-6050
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Provider Business Mailing Address
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Address Line | 970 S VILLAGE OAKS DR STE 102
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City | COVINA
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State | CA
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Zip | 91724-0609
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Country | US
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Telephone | 626-915-7490
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Fax | 626-951-7490
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Authorized Official
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Title or Position | COMPLIANCE
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Name | SYLVIE BOAL
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Credential |
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Telephone | 909-644-4965
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | HHA08076F
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License Number State | CA
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