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General NPI Number Information
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NPI Number | 1447067517
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Entity Type | Organization
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Legal Business Name | SHADDAI HOME CARE SERVICES LLC
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Dates
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Enumeration Date | 12/12/2024
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Last Update Date | 12/12/2024
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Provider Practice Location Address
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Address Line | 521 N MARKET ST APT 16
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City | INGLEWOOD
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State | CA
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Zip | 90302-3056
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Country | US
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Telephone | 323-612-9579
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Fax |
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Provider Business Mailing Address
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Address Line | 521 N MARKET ST APT 16
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City | INGLEWOOD
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State | CA
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Zip | 90302-3056
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Country | US
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Telephone | 323-612-9579
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Fax |
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Authorized Official
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Title or Position | SNR MANAGER
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Name | NGOWARI BLESSING AMADI-EPELLE
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Credential | MD
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Telephone | 323-612-9579
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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