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General NPI Number Information
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NPI Number | 1336786490
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Entity Type | Organization
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Legal Business Name | SCOTT VILLAS CORP
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Dates
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Enumeration Date | 12/06/2019
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Last Update Date | 08/03/2023
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Provider Practice Location Address
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Address Line | 1560 MIDDLE LN
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City | HAYWARD
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State | CA
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Zip | 94545-1912
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Country | US
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Telephone | 510-390-8078
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Fax |
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Provider Business Mailing Address
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Address Line | 1560 MIDDLE LN
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City | HAYWARD
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State | CA
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Zip | 94545-1912
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Country | US
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Telephone | 510-782-8808
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Fax | 510-782-8807
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Authorized Official
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Title or Position | LVN
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Name | WENDY WONG
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Credential |
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Telephone | 510-390-8078
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174200000X
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Taxonomy Name | Meals Provider
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 177F00000X
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Taxonomy Name | Lodging Provider
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #4
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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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Taxonomy #5
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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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