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General NPI Number Information
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NPI Number | 1417352733
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Entity Type | Organization
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Legal Business Name | MULTI-SKILLED HOME CARE SERVICES, INC.
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Dates
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Enumeration Date | 10/29/2014
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Last Update Date | 10/29/2014
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Provider Practice Location Address
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Address Line | 19608 CAMINO DE ROSA
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City | WALNUT
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State | CA
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Zip | 91789-2103
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Country | US
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Telephone | 909-595-0200
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Fax | 909-595-1211
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Provider Business Mailing Address
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Address Line | 19608 CAMINO DE ROSA
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City | WALNUT
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State | CA
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Zip | 91789-2103
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Country | US
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Telephone | 909-595-0200
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Fax | 909-595-1211
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MISS DEANNA MAY SAN DIEGO
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Credential | REGISTERED NURSE
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Telephone | 909-595-0200
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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 | 980001455
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License Number State | CA
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