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General NPI Number Information
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NPI Number | 1164590246
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Entity Type | Organization
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Legal Business Name | NEVADA GEM HOME HEALTH
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Dates
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Enumeration Date | 11/30/2006
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Last Update Date | 05/10/2012
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Provider Practice Location Address
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Address Line | 17418 CHATSWORTH ST STE 200
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City | GRANADA HILLS
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State | CA
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Zip | 91344-7626
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Country | US
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Telephone | 818-832-1889
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Fax | 818-832-3112
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Provider Business Mailing Address
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Address Line | 17418 CHATSWORTH ST STE 200
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City | GRANADA HILLS
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State | CA
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Zip | 91344-7626
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Country | US
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Telephone | 818-832-1889
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Fax | 818-832-3112
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Authorized Official
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Title or Position | ADMINISTRATOR CEO
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Name | MR. RICHARD TANINGCO SR.
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Credential |
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Telephone | 818-832-1889
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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 | 980001122
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License Number State | CA
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