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NPI 1205422185

NPI 1205422185 : HUB ZONE ENTERPRISES, INC. : LOS ANGELES, CA

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General NPI Number Information
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    NPI Number           |    1205422185
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    Entity Type          |    Organization 
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    Legal Business Name  |    HUB ZONE ENTERPRISES, INC. 
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Dates
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    Enumeration Date     |    12/15/2020
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    Last Update Date     |    12/15/2020
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Provider Practice Location Address
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    Address Line         |    1617 N EL CENTRO AVE STE 19 
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    City                 |    LOS ANGELES
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    State                |    CA
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    Zip                  |    90028-6429
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    Country              |    US
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    Telephone            |    323-432-0306
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1617 N EL CENTRO AVE STE 19 
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    City                 |    LOS ANGELES
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    State                |    CA
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    Zip                  |    90028-6429
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    DIRECTOR
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    Name                 |     VICTORIA  BOSMAN 
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    Credential           |    
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    Telephone            |    323-432-0306
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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       |    
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    License Number State |    
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