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General NPI Number Information
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NPI Number | 1215111588
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Entity Type | Organization
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Legal Business Name | ELEGANCE HEALTHCARE INC
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Dates
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Enumeration Date | 12/21/2007
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Last Update Date | 05/04/2011
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Provider Practice Location Address
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Address Line | 11026 VICTORY BLVD SUITE A
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91606-3720
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Country | US
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Telephone | 818-761-7786
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Fax | 818-761-7789
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Provider Business Mailing Address
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Address Line | 11026 VICTORY BLVD SUITE A
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91606-3720
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Country | US
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Telephone | 818-761-7786
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Fax | 818-761-7789
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Authorized Official
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Title or Position | PRES/CEO/CFO
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Name | MRS. MARINA ALEX BERMAN
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Credential |
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Telephone | 818-761-7786
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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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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 50001220
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License Number State | CA
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