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General NPI Number Information
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NPI Number | 1235887415
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Entity Type | Organization
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Legal Business Name | NURSE HAVEN HOME CARE AGENCY LLC
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Dates
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Enumeration Date | 03/16/2022
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Last Update Date | 03/16/2022
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Provider Practice Location Address
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Address Line | 4165 POWELL WAY UNIT 102
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City | CORONA
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State | CA
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Zip | 92883-4476
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Country | US
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Telephone | 714-702-5905
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Fax | 714-982-3383
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Provider Business Mailing Address
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Address Line | 4165 POWELL WAY UNIT 102
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City | CORONA
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State | CA
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Zip | 92883-4476
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Country | US
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Telephone | 714-702-5905
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Fax | 714-982-3383
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Authorized Official
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Title or Position | OWNER/CEO
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Name | LISA WOJCIK
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Credential |
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Telephone | 714-702-5905
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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