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General NPI Number Information
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NPI Number | 1265900062
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Entity Type | Organization
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Legal Business Name | ATHOME HOSPICE CARE LLC
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Dates
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Enumeration Date | 11/09/2018
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Last Update Date | 11/09/2018
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Provider Practice Location Address
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Address Line | 100 TOWER RD STE 15
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City | AMERICAN CANYON
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State | CA
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Zip | 94503-9650
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Country | US
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Telephone | 619-274-1392
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Fax |
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Provider Business Mailing Address
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Address Line | 100 TOWER RD STE 15
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City | AMERICAN CANYON
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State | CA
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Zip | 94503-9650
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Country | US
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Telephone | 619-274-1392
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JENNIVIVE VENZON
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Credential |
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Telephone | 619-274-1392
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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