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General NPI Number Information
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NPI Number | 1366178113
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Entity Type | Organization
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Legal Business Name | VAN HOME CARE LLC
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Dates
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Enumeration Date | 07/25/2022
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Last Update Date | 11/22/2022
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Provider Practice Location Address
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Address Line | 7322 SOUTHWEST FWY STE 1-0630B
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City | HOUSTON
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State | TX
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Zip | 77074-2010
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Country | US
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Telephone | 720-226-2311
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Fax |
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Provider Business Mailing Address
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Address Line | 570 LANSING ST
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City | AURORA
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State | CO
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Zip | 80010-4615
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Country | US
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Telephone | 720-226-2311
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | VINH THIET PHAM
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Credential |
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Telephone | 720-226-2311
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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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