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General NPI Number Information
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NPI Number | 1265970289
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Entity Type | Organization
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Legal Business Name | SMITTY'S HOME HEALTH
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Dates
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Enumeration Date | 02/09/2017
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Last Update Date | 03/17/2022
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Provider Practice Location Address
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Address Line | 10583 PORTLAND AVE
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City | HESPERIA
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State | CA
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Zip | 92345-2540
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Country | US
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Telephone | 909-244-4280
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Fax |
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Provider Business Mailing Address
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Address Line | 10583 PORTLAND AVE
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City | HESPERIA
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State | CA
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Zip | 92345-2540
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Country | US
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Telephone | 909-244-4280
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Fax |
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Authorized Official
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Title or Position | LVN/OWNER
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Name | BRITTNEY SMITH
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Credential | LVN
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Telephone | 909-244-4280
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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 | 266692
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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