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General NPI Number Information
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NPI Number | 1225274889
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Entity Type | Organization
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Legal Business Name | A AND S HOME CARE VILLA INC.
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Dates
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Enumeration Date | 12/31/2008
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Last Update Date | 12/31/2008
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Provider Practice Location Address
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Address Line | 21211 LEMARSH ST
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City | CHATSWORTH
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State | CA
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Zip | 91311-3016
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Country | US
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Telephone | 818-709-7179
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Fax | 818-709-4195
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Provider Business Mailing Address
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Address Line | 21211 LEMARSH ST
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City | CHATSWORTH
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State | CA
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Zip | 91311-3016
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Country | US
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Telephone | 818-709-7179
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Fax | 818-709-4195
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. AUSTIN BROWN EZEUKA
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Credential |
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Telephone | 818-709-7179
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 197607167
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License Number State | CA
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