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General NPI Number Information
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NPI Number | 1447232335
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Entity Type | Organization
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Legal Business Name | HOME REHABILITATION HEALTHCARE AGENCY INC.
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Dates
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Enumeration Date | 11/16/2005
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Last Update Date | 06/02/2016
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Provider Practice Location Address
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Address Line | 644 E REGENT ST SUITE 101
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City | INGLEWOOD
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State | CA
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Zip | 90301-4502
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Country | US
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Telephone | 310-677-4400
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Fax | 310-677-4407
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Provider Business Mailing Address
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Address Line | 644 E REGENT ST SUITE 101
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City | INGLEWOOD
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State | CA
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Zip | 90301-1433
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Country | US
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Telephone | 310-677-4400
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Fax | 310-677-4407
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Authorized Official
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Title or Position | DIRECTOR OF NURSING ADMINISTRATOR
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Name | MS. JOY TYSON
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Credential | RN BSN
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Telephone | 310-677-4400
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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 | 980001566
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License Number State | CA
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