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General NPI Number Information
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NPI Number | 1265722623
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Entity Type | Organization
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Legal Business Name | GANDSE HOME HEALTH CARE INC.
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Dates
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Enumeration Date | 04/19/2011
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Last Update Date | 04/19/2011
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Provider Practice Location Address
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Address Line | 26302 S. WESTERN AVE. SUITE 4
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City | LOMITA
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State | CA
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Zip | 90717-3537
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Country | US
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Telephone | 310-344-5924
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Fax |
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Provider Business Mailing Address
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Address Line | 26302 S. WESTERN AVE. SUITE 4
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City | LOMITA
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State | CA
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Zip | 90717-3537
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Country | US
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Telephone | 310-344-5924
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/ CEO
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Name | MR. WAHAB G BALOGUN
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Credential |
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Telephone | 310-344-5924
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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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