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General NPI Number Information
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NPI Number | 1356714034
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Entity Type | Organization
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Legal Business Name | COREVITACARE, INC.
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Dates
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Enumeration Date | 11/03/2015
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Last Update Date | 11/03/2015
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Provider Practice Location Address
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Address Line | 5173 DOUGLAS FIR RD
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City | CALABASAS
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State | CA
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Zip | 91302-1461
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Country | US
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Telephone | 888-808-0211
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Fax | 888-808-0311
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Provider Business Mailing Address
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Address Line | 5173 DOUGLAS FIR RD
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City | CALABASAS
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State | CA
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Zip | 91302-1461
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Country | US
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Telephone | 888-808-0211
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Fax | 888-808-0311
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. BELORIA FINK
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Credential |
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Telephone | 888-808-0211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | C3835333
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License Number State | CA
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