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General NPI Number Information
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NPI Number | 1194882530
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Entity Type | Organization
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Legal Business Name | VIRGINIA HOME CARE, INC.
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 11/18/2024
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Provider Practice Location Address
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Address Line | 1 W CALIFORNIA BLVD STE 226
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City | PASADENA
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State | CA
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Zip | 91105-3032
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Country | US
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Telephone | 626-796-5296
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Fax | 626-796-2678
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Provider Business Mailing Address
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Address Line | 1 W CALIFORNIA BLVD STE 226
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City | PASADENA
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State | CA
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Zip | 91105-3032
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Country | US
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Telephone | 626-796-5296
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Fax | 626-796-2678
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Authorized Official
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Title or Position | PRESIDENT
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Name | BRUCK MENGISTU
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Credential |
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Telephone | 626-796-5296
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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 | 980001396
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License Number State | CA
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