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General NPI Number Information
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NPI Number | 1306888029
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Entity Type | Organization
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Legal Business Name | WISDOM HEALTH CARE SERVICES INC.
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Dates
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Enumeration Date | 06/11/2006
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Last Update Date | 09/06/2023
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Provider Practice Location Address
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Address Line | 16921 S WESTERN AVE #219
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City | GARDENA
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State | CA
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Zip | 90247-5248
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Country | US
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Telephone | 310-324-3290
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Fax | 310-324-3614
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Provider Business Mailing Address
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Address Line | 16921 S WESTERN AVE #219
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City | GARDENA
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State | CA
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Zip | 90247-5248
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Country | US
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Telephone | 310-324-3290
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Fax | 310-324-3614
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MRS. AGATHA DICHE IBEKWE
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Credential | RN, PHN, BSN
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Telephone | 310-324-3290
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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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