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General NPI Number Information
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NPI Number | 1356007520
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Entity Type | Organization
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Legal Business Name | ST. JOHN'S HEALTHCARE SERVICES
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Dates
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Enumeration Date | 11/12/2021
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Last Update Date | 11/12/2021
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Provider Practice Location Address
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Address Line | 14545 FRIAR ST STE 322-2
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City | VAN NUYS
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State | CA
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Zip | 91411-2397
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Country | US
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Telephone | 818-426-7730
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Fax | 818-855-1925
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Provider Business Mailing Address
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Address Line | 14545 FRIAR ST STE 322-2
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City | VAN NUYS
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State | CA
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Zip | 91411-2397
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Country | US
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Telephone | 818-426-7730
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Fax | 818-855-1925
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Authorized Official
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Title or Position | CEO/CFO/SEC/OWNER
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Name | MRS. ARLENE V ROQUE
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Credential | LVN
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Telephone | 818-426-7730
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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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