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General NPI Number Information
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NPI Number | 1386840460
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Entity Type | Organization
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Legal Business Name | ENVISION HOME HEALTH SERVICE INC
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Dates
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Enumeration Date | 06/25/2007
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Last Update Date | 02/17/2022
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Provider Practice Location Address
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Address Line | 17725 CRENSHAW BLVD STE #302
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City | TORRANCE
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State | CA
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Zip | 90504
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Country | US
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Telephone | 310-515-1246
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Fax | 310-515-1721
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Provider Business Mailing Address
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Address Line | 17725 CRENSHAW BLVD STE #302
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City | TORRANCE
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State | CA
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Zip | 90504
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Country | US
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Telephone | 310-515-1246
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Fax | 310-515-1721
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Authorized Official
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Title or Position | CEO
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Name | KRISTINA KEGEYAN
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Credential |
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Telephone | 818-522-9252
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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 | NONE YET
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License Number State | CA
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