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General NPI Number Information
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NPI Number | 1386647931
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Entity Type | Organization
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Legal Business Name | VICTORIA HOME HEALTH NURSING AGENCY, INC.
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Dates
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Enumeration Date | 05/27/2005
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Last Update Date | 03/13/2008
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Provider Practice Location Address
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Address Line | 8455 BEVERLY BLVD STE 302
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City | LOS ANGELES
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State | CA
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Zip | 90048-3421
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Country | US
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Telephone | 323-653-3830
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Fax | 323-653-3880
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Provider Business Mailing Address
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Address Line | 8455 BEVERLY BLVD SUITE 302
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City | LOS ANGELES
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State | CA
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Zip | 90048-3416
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Country | US
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Telephone | 323-653-3830
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Fax | 323-653-3880
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Authorized Official
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Title or Position | ADMINISTRATOR DON
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Name | MISS LUCIA BASILIO INGENTE
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Credential | RN
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Telephone | 323-653-3830
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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 | CA
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